Fonseca Marta, Parreira Leonor, Farinha José Maria, Marinheiro Rita, Esteves Ana, Gonçalves Sara, Caria Rui
Centro Hospitalar de Setúbal, Cardiology Department, Setúbal, Portugal.
Indian Pacing Electrophysiol J. 2021 May-Jun;21(3):147-152. doi: 10.1016/j.ipej.2021.02.007. Epub 2021 Feb 16.
Premature ventricular contractions (PVCs) originating in the right ventricular outflow tract (RVOT) are traditionally considered idiopathic and benign. Echocardiographic conventional measurements are typically normal.
To assess whether right ventricle longitudinal strain, determined by two-dimensional speckle tracking echocardiography, differ between RVOT PVCs patients (treated with catheter ablation) and healthy controls.
We retrospectively selected patients with PVCs from the RVOT who underwent electrophysiological study and catheter ablation between 2016 and 2019. Patients with documented structural heart disease were excluded. Transthoracic echocardiography was performed and right ventricle global longitudinal strain (RV-GLS), free wall longitudinal strain (RVFW-LS) and left ventricle global longitudinal strain (LV-GLS) were determined as well as conventional ultrasound measurements of RV and LV function.
We studied 21 patients with RVOT PVCs and 13 controls. Patients with PVCs from the RVOT had lower values of RV-GLS and RVFW-LS compared with the control group (-19.4% versus -22.5%, P = 0.015 and -22.1% versus -25.5, P = 0.041, respectively). They also had lower values of LV-GLS, although still within the normal range (-19.1% versus -20.9%, P = 0.047). Regarding RVOT PVCs patients only, RV-GLS and RVFW-LS had no correlation with the PVCs burden prior to catheter ablation and they did not differ between the patients in whom the catheter ablation was successful and those in whom it was not. RV-GLS also had a positive correlation with RVOT proximal diameter (r = 0.487, P = 0.025).
In this group of RVOT PVCs patients, we found worse RV longitudinal strain values (and therefore sub-clinical myocardial dysfunction) when compared to healthy controls.
起源于右心室流出道（RVOT）的室性早搏（PVCs）传统上被认为是特发性和良性的。超声心动图常规测量通常正常。
评估通过二维斑点追踪超声心动图测定的右心室纵向应变在RVOT PVCs患者（接受导管消融治疗）和健康对照之间是否存在差异。
我们回顾性选择了2016年至2019年间接受电生理研究和导管消融的RVOT PVCs患者。排除有明确结构性心脏病的患者。进行经胸超声心动图检查，测定右心室整体纵向应变（RV-GLS）、游离壁纵向应变（RVFW-LS）和左心室整体纵向应变（LV-GLS）以及RV和LV功能的常规超声测量值。
我们研究了21例RVOT PVCs患者和13例对照。与对照组相比，RVOT PVCs患者的RV-GLS和RVFW-LS值较低（分别为-19.4%对-22.5%，P = 0.015；-22.1%对-25.5%，P = 0.041）。他们的LV-GLS值也较低，尽管仍在正常范围内（-19.1%对-20.9%，P = 0.047）。仅就RVOT PVCs患者而言，RV-GLS和RVFW-LS与导管消融前的PVCs负荷无相关性，且在导管消融成功和未成功的患者之间无差异。RV-GLS也与RVOT近端直径呈正相关（r = 0.487，P = 0.025）。
在这组RVOT PVCs患者中，我们发现与健康对照相比，RV纵向应变值更差（因此存在亚临床心肌功能障碍）。
