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Cardiac risk factors and prevention
Original article
Risk factors for premature ventricular contractions in young and healthy adults
  1. Mirco von Rotz1,2,
  2. Stefanie Aeschbacher1,2,
  3. Matthias Bossard2,3,4,
  4. Tobias Schoen2,5,
  5. Steffen Blum1,2,
  6. Susanna Schneider2,
  7. Joel Estis6,
  8. John Todd6,
  9. Martin Risch7,8,
  10. Lorenz Risch7,9,10,
  11. David Conen1,2,3,11
  1. 1Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland
  2. 2Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Basel, Switzerland
  3. 3Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Hamilton, Ontario, Canada
  4. 4Division of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada
  5. 5Cardiology Division, Department of Medicine, University Hospital Basel, Basel, Switzerland
  6. 6Singulex, Alameda, California, USA
  7. 7Labormedizinisches Zentrum Dr Risch, Schaan, Liechtenstein
  8. 8Division of Laboratory Medicine, Kantonsspital Graubünden, Chur, Switzerland
  9. 9Division of Clinical Biochemistry, Medical University, Innsbruck, Austria
  10. 10Private University, Triesen, Liechtenstein
  11. 11Cardiology Division, St. Joseph's Healthcare, Hamilton, Ontario, Canada
  1. Correspondence to David Conen MD, MPH Population Health Research Institute, McMaster University, 237 Barton Street, East Hamilton, ON L8L 2X2, Canada; conend{at}mcmaster.ca

Abstract

Background Premature ventricular contractions (PVCs) are associated with an increased risk of morbidity and mortality. Therefore, it was aimed to assess risk factors for the frequency of PVCs in young and healthy adults.

Methods Our population-based study included 2048 healthy adults from the general population aged 25–41 years. PVC frequency was determined by 24-hour Holter ECG. We performed multivariable regression analysis using stepwise backward selection to identify factors independently associated with PVC frequency.

Results Median age was 37 years, 953 (46.5%) were male. At least one PVC during the 24-hour monitoring period was observed in 69% of participants. Median number of detected PVCs was 2, the 95th percentile was 193. In multivariable regression analyses, we found 17 significant risk factors for PVC frequency. Low educational status (risk ratio (RR) 3.33; 95% CI 1.98 to 5.60), body height>median (1.58, 95% CI 1.11 to 2.24) and increasing levels of waist:hip ratio (2.15, 95% CI 1.77 to 2.61), N-terminal pro brain natriuretic peptide (1.52, 95% CI 1.30 to 1.76) and Sokolow-Lyon Index (1.38, 95% CI 1.15 to 1.66) (all p≤0.01) were associated with a higher PVC frequency. Physical activity (RR fourth vs first quartile 0.51, 95% CI 0.34 to 0.76) and increasing levels of haemoglobin (0.58, 95% CI 0.47 to 0.70) and glucagon-like peptide-1 (0.72, 95% CI 0.64 to 0.82) (all p<0.001) were related to a lower PVC frequency.

Conclusions PVC occurrence is common even in healthy low-risk individuals, and its frequency is associated with several covariates mainly related to cardiovascular risk factors, markers of cardiac structure and function and socioeconomic status.

https://doi.org/10.1136/heartjnl-2016-309632

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    Footnotes

    • Contributors Data collection: MvR, SA, MB, SB and SS. Statistical analysis: MvR, SA, TS and DC. Principal investigators: DC, LR and MR. Analysis biomarkers: JT and JE. Draft manuscript: MvR and DC. Careful editing of the manuscript: SA, MB, TS, SB, SS, JE, JT, MR, LR, DC and MvR.

    • Funding The GAPP study was supported by the Liechtenstein Government, the Swiss Heart Foundation, the Swiss Society of Hypertension, the University of Basel, the University Hospital Basel, the Hanela Foundation, Schiller AG and Novartis. DC was supported by a grant of the Swiss National Science Foundation (PP00P3_133681 and PP00P3_159322). MB was supported by a grant of the University of Basel and Freiwillige Akademische Gesellschaft (FAG) Basel. Plasma levels of high sensitivity cardiac troponin I, endothelin-1 and glucagon-like peptide-1 were determined free of charge by Singulex.

    • Competing interests JE and JT are employees of Singulex.

    • Patient consent Obtained.

    • Ethics approval Ethikkommission Zürich, Switzerland.

    • Provenance and peer review Not commissioned; externally peer reviewed.