Sukru Arslan, Ozan Arabaci H, Furkan Deniz M, Emin Gokce M, Seyma Arslan, Veysel Oktay, Mustafa Yıldız, Isıl Uzunhasan
Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, 34303 Istanbul, Turkey.
Republic of Turkey Ministry of Health, 06800 Ankara, Turkey.
J Clin Med. 2024 Mar 20;13(6):1796. doi: 10.3390/jcm13061796.
Evaluation of left ventricular (LV) function in patients with idiopathic premature ventricular contraction (PVC) with preserved LV ejection fraction (LVEF), especially in the subclinical stage, may be of great importance in terms of directing early treatment. A total of 122 patients, retrospectively recruited, were divided into three groups according to PVC burden: Group 1; 5% ≤ PVC < 10%, Group 2; 10% ≤ PVC < 15%, and Group 3; 15% ≤ PVC. Transthoracic echocardiography (TTE) was performed to evaluate LV parameters. LV-GLS (Global longitudinal strain) was found to be significantly lower in groups 2 and 3 with high PVC burden (18.9% ± 1.4, 17.5% ± 2.1, 16.3% ± 1.3; < 0.001, respectively). Correlation analysis revealed a positive and significant correlation between PVC burden and deterioration in LV-GLS (r: 0.536; < 0.001). In addition, PVC burden was found to be an independent predictor of LV-GLS deterioration in multiple linear regression analysis (β: 0.525, < 0.001). The ROC curve analysis demonstrated that a PVC burden cut-off value of 8.4% was associated with a LV-GLS deterioration greater than -18, with a specificity of 75.4% and a sensitivity of 75.4% (AUC: 0.81 [0.73-0.88] 95% CI; < 0.001). PVC burden was an independent predictor of deterioration in LV-GLS. The presence of LV-GLS deterioration due to PVC burden emphasizes the necessity for closer patient monitoring, observation of the response to pharmacological treatment, and evaluation of early invasive treatment strategies in selected patient groups.
对于左心室射血分数（LVEF）保留的特发性室性早搏（PVC）患者，尤其是亚临床阶段的患者，评估左心室（LV）功能对于指导早期治疗可能非常重要。回顾性招募了122例患者，根据PVC负荷分为三组：第1组，5%≤PVC<10%；第2组，10%≤PVC<15%；第3组，15%≤PVC。进行经胸超声心动图（TTE）以评估左心室参数。发现PVC负荷高的第2组和第3组的左心室整体纵向应变（LV-GLS）显著降低（分别为18.9%±1.4、17.5%±2.1、16.3%±1.3；P<0.001）。相关性分析显示PVC负荷与LV-GLS恶化之间存在正相关且具有显著相关性（r：0.536；P<0.001）。此外，在多元线性回归分析中，PVC负荷被发现是LV-GLS恶化的独立预测因子（β：0.525，P<0.001）。ROC曲线分析表明，PVC负荷截断值为8.4%与LV-GLS恶化大于-18相关，特异性为75.4%，敏感性为75.4%（AUC：0.81[0.73-0.88]95%CI；P<0.001）。PVC负荷是LV-GLS恶化的独立预测因子。由于PVC负荷导致的LV-GLS恶化的存在强调了对患者进行更密切监测、观察药物治疗反应以及评估特定患者群体早期侵入性治疗策略的必要性。
