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Review
. 2021 May-Jun:66:17-27.
doi: 10.1016/j.pcad.2021.04.001. Epub 2021 Apr 20.

Clinical and translational insights on premature ventricular contractions and PVC-induced cardiomyopathy

Jose F Huizar  1 , Alex Y Tan  2 , Karoly Kaszala  2 , Kenneth A Ellenbogen  3
Affiliations
Review

Clinical and translational insights on premature ventricular contractions and PVC-induced cardiomyopathy

Jose F Huizar et al. Prog Cardiovasc Dis. 2021 May-Jun.

Abstract

The medical community's understanding of the consequences of premature ventricular contractions (PVCs) and PVC-induced cardiomyopathy has been derived mostly from observational and large population-based studies. Due to the difficulty of predicting the development of PVC-cardiomyopathy, the acute and chronic cardiac effects of PVCs and the mechanism of PVC-cardiomyopathy have been derived from pre-clinical studies with large animal models. Recently, these studies have described myocardial substrates that could potentially increase morbidity and mortality in patients with frequent PVCs and PVC-cardiomyopathy. In this paper, we provide an up-to-date comprehensive review of these pre-clinical and clinical studies.

Keywords: Eccentric hypertrophy; Heart rate irregularity; LV dyssynchrony; Premature atrial contraction; Premature ventricular contraction.

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Figures

Figure 1.
Figure 1.
Potential triggers of PVCs and substrate and outcomes of PVC-cardiomyopathy.
Figure 2.
Figure 2.
Linear decline of LVEF appears proportional to PVC burden in (A) clinical and (B) translational animal model (reproduced with permission, Tan et.al [15, 52]).
Figure 3.
Figure 3.
Comparison of event-free survival (death and resuscitated cardiac arrest) in patients with diagnosis of PVC-cardiomyopathy from the CHF-STAT study (A) overall population (n=421) and (B) amiodarone-only treated group (n=203) (reproduced with permission, Huizar et.al.[5]).
Figure 4.
Figure 4.
Substrate for the development of ventricular arrhythmias in PVC-cardiomyopathy (reproduced with permission, Huizar et.al.[60]).
See this image and copyright information in PMC

References

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