Assessment of the effects of frequent ventricular extra systoles on the left ventricle function using two-dimensional speckle tracking echocardiography in apparently normal hearts

Abstract

Background: premature ventricular contractions are commonly seen within the general population and frequently observed during clinical practice. In recent years studies have shown that athough PVCs was considered as mostly benign, frequent PVCs without structural heart disease might lead to cardiac dysfunction and even cardiomyopathy, more recent work has revealed that PVCs can contribute to cardiomyopathy and heart failure and treating PVCs could lead to improved cardiac function. Aim of the Work: the aim of this work was to assess the effect of ventricular extrasystoles (VESs) on LV function by using 2D-STE for early detection of subtle LV dysfunction in patients with apparently normal hearts and assess correlation between frequency of extrasystole and degree of impairment of LV dysfunction. Patients and Methods: the ethical approval was obtained from the hospital ethical research committee and each patient entering the study was signed an informed consent. Fifty patients were included in this study with asymptomatic frequent PVCs. All were without structural heart disease. Detailed history, physical examination, full labs, resting ECG, Holter monitoring for 24 hours, conventional ECHO assessment and finally strain imaging with measurement of LV-GLS were done. They were recruited from Cardiovascular Department at Sayed Galal University Hospitals during the period from December 2017 to November 2018. In this study we assessed speckle tracking of LV in apparently normal patients with frequent PVCs. Results: early detection of subtle LV dysfunction was done by speckle tracking echocardiographic modalities other than conventional echocardiographic and showed a significant correlation with PVCs burden, focality, interpolated PVCs and duration of the complex of ectopic beat.Conclusion: frequent PVCs may produce LV dysfunction and cardiomyopathy independently of any pre-existing underlying cardiac disease and early detection of subtle LV dysfunction can be done by speckle tracking echocardiographic modalities even in asymptomatic patient.