Hemodynamic consequences of premature ventricular contractions: Association of mechanical bradycardia and postextrasystolic potentiation with premature ventricular contraction-induced cardiomyopathy

被引:12
|
作者
Billet, Sophie [1 ]
Rollin, Anne [1 ]
Mondoly, Pierre [1 ]
Monteil, Benjamin [1 ]
Fournier, Pauline [1 ]
Cariou, Eve [1 ]
Blaye-Felice, Marie Sadron [1 ]
Galinier, Michel [1 ]
Carrie, Didier [1 ]
Lairez, Olivier [1 ]
Delmas, Clement [1 ]
Maury, Philippe [1 ,2 ]
机构
[1] Univ Hosp Rangueil, Dept Cardiol, Toulouse, France
[2] Unite Inserm U 1048, Toulouse, France
关键词
Ablation; Cardiomyopathy; Mechanical bradycardia; Postextrasystolic potentiation; Premature ventricular contraction; STRUCTURAL HEART-DISEASE; OXYGEN-CONSUMPTION; COUPLING INTERVAL; ABLATION; ELECTROAUGMENTATION; PERFORMANCE; DYSFUNCTION; COMPLEXES; REVERSAL; RECOVERY;
D O I
10.1016/j.hrthm.2018.12.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND The relationships between hemodynamic consequences of premature ventricular contractions (PVCs) and development of premature ventricular contraction-induced cardiomyopathy (PVC-CM) have not been investigated. OBJECTIVE The purpose of this study was to correlate concealed mechanical bradycardia and/or postextrasystolic potentiation (PEP) to PVC-CM. METHODS Invasive arterial pressure measurements from 17 patients with PVC-CM and 16 controls with frequent PVCs were retrospectively analyzed. PVCs were considered efficient (ejecting PVCs) when generating a measurable systolic arterial pressure. PEP was defined by a systolic arterial pressure of the post-PVC beat >= 5 mm Hg higher than the preceding sinus beat. Every PVC was analyzed for 10 minutes before ablation, and the electromechanical index (EMi = number of ejecting PVCs/total PVC) and postextrasystolic potentiation index (PEPi = number of PVCs with PEP/total PVC) were calculated. RESULTS EMi was 29% +/- 31% in PVC-CM and 78% +/- 20% in controls (P <.0001). PEPi was 41% +/- 28% in PVC-CM and 14% +/- 10 % in controls (P = .001). There was no control in groups of low EMi or high PEPi. EMi and PEPi were not significantly correlated to left ventricular dimensions or function in PVC-CM patients. PVC coupling interval was related to both ejecting PVCs and PEP. CONCLUSION Patients with PVC-CM more often display nonejecting PVCs and PEP compared to controls.
引用
收藏
页码:853 / 860
页数:8
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