RT Journal Article
SR Electronic
T1 Premature ventricular complexes and development of heart failure in a community-based population
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 105
OP 110
DO 10.1136/heartjnl-2021-319473
VO 108
IS 2
A1 Limpitikul, Worawan B
A1 Dewland, Thomas A
A1 Vittinghoff, Eric
A1 Soliman, Elsayed
A1 Nah, Gregory
A1 Fang, Christina
A1 Siscovick, David S
A1 Psaty, Bruce M
A1 Sotoodehnia, Nona
A1 Heckbert, Susan
A1 Stein, Phyllis K
A1 Gottdiener, John
A1 Hu, Xiao
A1 Hempfling, Ralf
A1 Marcus, Gregory M
YR 2022
UL http://heart.bmj.com/content/108/2/105.abstract
AB Objective A higher premature ventricular complex (PVC) frequency is associated with incident congestive heart failure (CHF) and death. While certain PVC characteristics may contribute to that risk, the current literature stems from patients in medical settings and is therefore prone to referral bias. This study aims to identify PVC characteristics associated with incident CHF in a community-based setting.Methods The Cardiovascular Health Study is a cohort of community-dwelling individuals who underwent prospective evaluation and follow-up. We analysed 24-hour Holter data to assess PVC characteristics and used multivariable logistic and Cox proportional hazards models to identify predictors of a left ventricular ejection fraction (LVEF) decline and incident CHF, respectively.Results Of 871 analysed participants, 316 participants exhibited at least 10 PVCs during the 24-hour recording. For participants with PVCs, the average age was 72±5 years, 41% were women and 93% were white. Over a median follow-up of 11 years, 34% developed CHF. After adjusting for demographics, cardiovascular comorbidities, antiarrhythmic drug use and PVC frequency, a greater heterogeneity of the PVC coupling interval was associated with an increased risk of LVEF decline and incident CHF. Of note, neither PVC duration nor coupling interval duration exhibited a statistically significant relationship with either outcome.Conclusions In this first community-based study to identify Holter-based features of PVCs that are associated with LVEF reduction and incident CHF, the fact that coupling interval heterogeneity was an independent risk factor suggests that the mechanism of PVC generation may influence the risk of heart failure.Data may be obtained from a third party and are not publicly available.