Alimi Hedieh, Bigdelu Leila, Poorzand Hoorak, Ghaderi Fereshteh, Fazlinejad Afsoon, Emadzadeh Maryam, Ataei Banafsheh, Kerachian Abdollah
Assistant Professor of Cardiology, Vascular and Endovascular Surgery Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Associate Professor of Cardiology, Vascular and Endovascular Surgery Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
ARYA Atheroscler. 2022 Mar;18(2):1-7. doi: 10.48305/arya.2022.16310.
Premature ventricular contractions (PVCs) are early depolarizations of the myocardium which originate from the ventricle. PVCs have previously been considered a benign condition. The clinical significance of PVCs in patients without structural heart disease is controversial.
In this cross-sectional study, patients with a palpitation complaint who underwent electrocardiography (ECG) Holter recording for 48 hours were analyzed. Patients with frequent PVCs (more than ten times in 1 hour) were identified and enrolled in the study. 26 patients were in the PVC group, and 26 patients were in the control group without PVC. The identified patients underwent an echocardiographic examination with strain modality.
There were 15 women (57.7%) in the PVC group and 17 women (65.4%) in the control group (P = 0.57). Two patients in the PVC group and three patients in the control group were hypertensive (P > 0.99). There was only one patient with diabetes in PVC and control group (P > 0.99). There were two smokers in the PVC group, whereas there was no smoker in the control group (P = 0.49). In comparison between two groups, patients with frequent PVCs had significantly larger left ventricular end-diastolic volume index (LVEDVI) (P = 0.048) along with lower left ventricular ejection fraction (LVEF) (P = 0.011), lower (more positive) left ventricular global longitudinal strain (LVGLS) (P = 0.001), and lower peak systolic mitral annular velocity (S') (P = 0.045). The left atrial volume index (LAVI) was significantly larger in the PVC group (P = 0.001). In speckle tracking echocardiography (STE) parameters, global peak atrial longitudinal strain (PALS) (P = 0.001) and peak atrial contraction strain (PACS) (P = 0.001) were significantly lower and time to peak longitudinal strain (TPLS) (P = 0.002) was significantly higher in the PVC group.
In this study, left atrial (LA) and left ventricular (LV) function and geometry were adversely affected by frequent PVCs. Early diagnosis of these effects is possible with echocardiography along with strain analysis. It can guide the timely treatment of PVC to avoid the harmful effects of frequent PVCs on the heart.
室性早搏（PVCs）是起源于心室的心肌早期去极化。PVCs以前被认为是一种良性病症。无结构性心脏病患者中PVCs的临床意义存在争议。
在这项横断面研究中，对因心悸主诉而接受48小时心电图（ECG）动态记录的患者进行了分析。确定有频发PVCs（1小时内超过10次）的患者并纳入研究。PVC组有26例患者，无PVC的对照组有26例患者。确定的患者接受了带应变模式的超声心动图检查。
PVC组有15名女性（57.7%），对照组有17名女性（65.4%）（P = 0.57）。PVC组有2例患者、对照组有3例患者患有高血压（P > 0.99）。PVC组和对照组各有1例糖尿病患者（P > 0.99）。PVC组有2名吸烟者，而对照组无吸烟者（P = 0.49）。两组比较，频发PVCs患者的左心室舒张末期容积指数（LVEDVI）显著更大（P = 0.048），同时左心室射血分数（LVEF）更低（P = 0.011），左心室整体纵向应变（LVGLS）更低（更正）（P = 0.001），以及收缩期二尖瓣环峰值速度（S'）更低（P = 0.045）。PVC组的左心房容积指数（LAVI）显著更大（P = 0.001）。在斑点追踪超声心动图（STE）参数方面，PVC组的整体心房纵向应变峰值（PALS）（P = 0.001）和心房收缩应变峰值（PACS）（P = 0.001）显著更低，纵向应变峰值时间（TPLS）（P = 0.002）显著更高。
在本研究中，频发PVCs对左心房（LA）和左心室（LV）的功能及形态产生了不利影响。通过超声心动图及应变分析可以早期诊断这些影响。它可以指导PVC的及时治疗，以避免频发PVCs对心脏的有害影响。
