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Multicenter Study
. 2020 Mar;25(2):e12702.
doi: 10.1111/anec.12702. Epub 2019 Sep 22.

The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction

Bernas Altıntaş  1 , Flora Özkalaycı  2 , Göksel Çinier  3 , İlyas Kaya  1 , Adem Aktan  4 , Ayhan Küp  5 , Raşit Onuk  6 , Sevgi Özcan  7 , Abdulkadir Uslu  5 , Abdurrahman Akyüz  1 , Adem Atıcı  8 , Selim Ekinci  9 , Halil Akın  10 , Mehmet Fatih Yılmaz  11 , Şahbender Koç  12 , Veysel Ozan Tanık  13 , Hazar Harbalıoğlu  14 , Hasan Ali Barman  7 , Abdülmecit Afşin  15 , Ayça Gümüşdağ  16 , Hayrudin Alibaşiç  17 , Yavuz Karabağ  18 , Murat Cap  1 , Erkan Baysal  1 , İbrahim Halil Tanboğa  2   19
Affiliations
Multicenter Study

The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction

Bernas Altıntaş et al. Ann Noninvasive Electrocardiol. 2020 Mar.

Abstract

Aim: Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF).

Method: This multicenter, cross-sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination.

Result: Overall, the median age was 50 (38-60) and 139 (49.4%) were female. Percentage of median PVC burden was 9% (IQR: 4%-17.4%). Median LVEF was found 60% (55-65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (%) (regression coefficient (RE) -0.644 and 95% CI -1.063, -0.225, p < .001), PVC QRS duration (RE-0.191 and 95% CI -0.529, 0.148, p = .049), and age (RE-0.249 and 95% CI -0.442, -0.056, p = .018) were associated with decrease in LVEF. This inverse relationship between the PVC burden and LVEF become more prominent when PVC burden was above 5%. A nomogram developed to estimate the individual risk for decrease in LVEF.

Conclusion: Our study showed that increase in PVC burden %, age, and PVC QRS duration were independently associated with decrease in LVEF in patients with idiopathic PVC. Also, inverse relationship between PVC burden and LVEF was observed in lower PVC burden than previously known.

Keywords: cardiomyopathy; left ventricular ejection fraction; premature ventricular complexes.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
The frequency distribution of PVC burden (%). PVC, premature ventricular complex
Figure 2
Figure 2
Partial effect plot of PVC burden (%). Red line represents the beginning of LVEF decline. Interacting with LVEF began when PVC burden was >5%. LVEF, left ventricular ejection fraction; PVC, premature ventricular complex
Figure 3
Figure 3
Three‐dimensional perspective plot for PVC burden (%) and age interaction. PVC, premature ventricular complex
Figure 4
Figure 4
Importance of individual predictors. The importance of each predictor in the full model was calculated as the proportion of explainable outcome variation contributed by each predictor (partial chi‐square value for each predictor divided by the model's total chi‐square)
Figure 5
Figure 5
Nomogram for estimating the probability of LVEF ≤ 40%, LVEF ≤ 50%. AA, antiarrhythmic drug; LVEF, left ventricular ejection fraction
See this image and copyright information in PMC

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