Association of premature ventricular complex burden with elevated left ventricular filling pressure

Abstract

Premature ventricular contraction (PVC) is considered one of the most common arrhythmias in clinical practice. The aetiology of PVC is still unclear, however increased sympathetic activity, electrolyte misbalance and cardiomyopathies are considered the main causes of PVCs. In this study we were trying to find out whether there was any association between PVC burden and elevated left ventricular (LV) filling pressure. A total of 100 patients (age: 58.6 ± 7.5 years, 52 males) with frequent PVCs observed on 24-hour Holter monitoring (> 1%) and normal LV ejection fraction (LVEF) (> 50% on echocardiography) were enrolled. Clinical characteristics and echocardiographic parameters, including E/E' to assess LV filling pressure of the patients, were compared with those of an age- and gender-matched control group (n = 100, age: 57.4 ± 7.5 years, 50 males). Mean E' was significantly higher in the controls (7.9 ± 3.1 cm/s) than the cases (6.4 ± 1.9 cm/s) (p = 0.010) while mean E/E' was significantly higher in the cases (12.5 ± 5.3) than the controls (10.9 ± 5.7) (p = 0.044), reflecting significantly different LV diastolic function. However LVEF by M-mode and biplane imaging showed no significant difference between the groups. Patients with frequent PVCs were associated with high LV filling pressure, which was significantly different from LV filling pressure in the control group.