Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA; Department of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
JACC Clin Electrophysiol. 2023 Feb;9(2):192-199. doi: 10.1016/j.jacep.2022.09.016. Epub 2022 Nov 23.
Frequent premature ventricular complexes (PVCs) can result in a reversible form of cardiomyopathy that usually affects the left ventricle (LV).
The objective of this study was to assess whether frequent PVCs have an impact on right ventricular (RV) function.
Serial cardiac magnetic resonance (CMR) studies were performed in a series of 47 patients before and after ablation of frequent PVCs.
Patients with RV cardiomyopathy (ejection fraction [EF] <0.45) had more frequent PVCs than did patients without decreased RV function (23% ± 11% vs 15% ± 11%, P = 0.03). Likewise, patients with LV cardiomyopathy (EF <0.50) had more frequent PVCs than did patients without decreased LV function (23% ± 10% vs 14% ± 12%, P = 0.003). LV dysfunction was present in 21 patients (45%). In patients with LV dysfunction, 15 patients (32%) had biventricular dysfunction, and 6 patients (13%) had isolated LV dysfunction. A total of 19 patients (40%) had RV dysfunction, and 4 of the patients with RV dysfunction (9%) had isolated RV dysfunction. Cardiac magnetic resonance was repeated 1.9 ± 1.3 years after ablation. In patients with successful ablation, RV function improved, and in patients without successful ablation, RV function did not significantly change (before and after ablation RVEF 0.45 ± 0.09 and 0.52 ± 0.09; P < 0.001 vs. 0.46 ± 0.07 and 0.48 ± 0.04; P = 0.14, respectively).
Frequent PVCs can cause RV cardiomyopathy that parallels LV cardiomyopathy and is reversible with successful ablation.
频繁的室性早搏（PVCs）可导致一种通常影响左心室（LV）的可逆性心肌病。
本研究旨在评估频发 PVCs 是否对右心室（RV）功能有影响。
对 47 例频发 PVCs 消融前后的患者进行了一系列连续的心脏磁共振（CMR）研究。
与 RV 功能正常的患者相比，RV 心肌病（射血分数 [EF]＜0.45）患者的 PVCs 更频繁（23%±11%比 15%±11%，P=0.03）。同样，与 LV 功能正常的患者相比，LV 心肌病（EF＜0.50）患者的 PVCs 更频繁（23%±10%比 14%±12%，P=0.003）。21 例患者（45%）存在 LV 功能障碍。在 LV 功能障碍的患者中，15 例（32%）为双心室功能障碍，6 例（13%）为孤立性 LV 功能障碍。共有 19 例（40%）患者存在 RV 功能障碍，其中 4 例（9%）为孤立性 RV 功能障碍。消融后 1.9±1.3 年重复进行心脏磁共振检查。在消融成功的患者中，RV 功能得到改善，而在消融不成功的患者中，RV 功能没有显著变化（消融前后 RVEF 分别为 0.45±0.09 和 0.52±0.09；P＜0.001，与 0.46±0.07 和 0.48±0.04；P=0.14）。
频发 PVCs 可导致与 LV 心肌病相似的 RV 心肌病，且可通过成功消融得到逆转。
