Pay Levent, Tezen Ozan, Çetin Tuğba, Eren Semih, Öz Melih, Coşkun Cahit, Yumurtaş Ahmet Çağdaş, Karabacak Cemre, Yenitürk Birkan, Çınar Tufan, Hayıroğlu Mert İlker
Department of Cardiology, Ardahan State Hospital.
Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training Hospital.
Acta Cardiol Sin. 2024 May;40(3):267-274. doi: 10.6515/ACS.202405_40(3).20231227A.
The treadmill exercise test is widely used to determine cardiovascular risk and mortality. Premature ventricular complexes (PVCs) are frequently observed during exercise stress testing. The literature on the role of PVCs observed during treadmill exercise testing in predicting prognosis is controversial. Hence, we aimed to evaluate the clinical results of PVCs seen during exercise testing in patients without obstructive coronary artery disease confirmed by coronary angiography (CAG).
The study population consisted of 1624 consecutive patients who were considered high risk according to the Duke treadmill risk score and had no significant stenosis on CAG from January 2016 to April 2021. The primary endpoints of the study were long-term all-cause mortality of patients who had PVCs during the exercise test or during the resting phase.
Long-term mortality was observed in 53 of the 1624 patients after a mean follow-up of 47 months. PVCs were observed in 293 (18.7%) patients without long-term mortality, and in 24 (45.3%) patients with long-term mortality (p < 0.001). The model adjusted for all covariates showed that the presence of PVCs in the recovery phase [p < 0.007, hazard ratio (HR) (95% confidence interval (CI)) 2.244 (1.244-4.047)] and advanced age [p < 0.001, HR (95% CI) 1.194 (1.143-1.247)] were associated with long-term all-cause mortality.
PVCs observed during treadmill exercise testing and the recovery phase were related to long-term mortality in patients without obstructive coronary artery disease.
跑步机运动试验广泛用于确定心血管风险和死亡率。运动负荷试验期间经常观察到室性早搏（PVCs）。关于跑步机运动试验期间观察到的PVCs在预测预后中的作用的文献存在争议。因此，我们旨在评估在经冠状动脉造影（CAG）证实无阻塞性冠状动脉疾病的患者运动试验期间出现的PVCs的临床结果。
研究人群包括2016年1月至2021年4月期间根据杜克跑步机风险评分被认为是高危且CAG无明显狭窄的1624例连续患者。该研究的主要终点是运动试验期间或静息期出现PVCs的患者的长期全因死亡率。
1624例患者中，平均随访47个月后有53例出现长期死亡。在无长期死亡的293例（18.7%）患者和有长期死亡的24例（45.3%）患者中观察到PVCs（p<0.001）。对所有协变量进行调整后的模型显示，恢复期出现PVCs [p<0.007，危险比（HR）（95%置信区间（CI））2.244（1.244 - 4.047）]和高龄 [p<0.001，HR（95%CI）1.194（1.143 - 1.247）]与长期全因死亡率相关。
跑步机运动试验和恢复期观察到的PVCs与无阻塞性冠状动脉疾病患者的长期死亡率相关。
