Premature ventricular contractions on healthy and diseased hearts: Differential acute effect of coupling interval and location.

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-09-26 DOI:10.1016/j.hrthm.2025.09.035

Marc Soriano-Amores, Zoraida Moreno-Weidmann, Esther Jorge, Andreu Ferrero-Gregori, Bieito Campos-García, Sergi Casabella-Ramón, Concepción Alonso-Martín, Enrique Rodríguez-Font, Chi-Hion Li, Xavier Viñolas, Vicenta Llorente-Cortés, Sònia Mirabet-Pérez, Gerard Amorós-Figueras, Jose M Guerra

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引用次数: 0

Abstract

Background: The precise pathophysiological mechanisms underlying premature ventricular contraction (PVC)-induced cardiomyopathy remain unclear.

Objective: This study aimed to compare the acute physiological effects of PVCs delivered at different coupling intervals (CIs) and anatomic sites in healthy hearts and in hearts with an established dilated cardiomyopathy.

Methods: 10 swine were studied: 5 served as controls, and 5 underwent pacemaker implantation with 180 beats/min pacing for 4 weeks to induce nonischemic dilated cardiomyopathy (NIDCM). PVCs were delivered from 14 left ventricular (LV) and 6 right ventricular sites at 4 CIs in both groups. QRS duration and hemodynamic parameters (aortic flow, maximal rate of pressure rise, and maximal rate of pressure fall) were assessed.

Results: PVC QRS duration increased as CI shortened in both groups (control 85 ± 7 ms at 500 ms vs 93 ± 7 ms at 350 ms, P < .01; NIDCM 103 ± 6 ms vs 119 ± 6 ms, P < .01). Hemodynamic deterioration paralleled QRS prolongation and was more pronounced in the NIDCM group. PVCs from the LV had a greater hemodynamic impact.

Conclusion: Shorter PVC CIs prolong QRS duration and worsen hemodynamics, with these effects more pronounced in the dilated cardiomyopathic hearts. This could correlate with a greater long-term decline in the LV ejection fraction, thereby increasing the risk of developing PVC-induced cardiomyopathy.

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健康和病变心脏的室性早搏：耦合间隔和位置的不同急性效应。

背景：室性早搏诱发心肌病的确切病理生理机制尚不清楚。目的：比较健康心脏和扩张型心肌病心脏在不同耦合间隔和解剖部位传递早搏的急性生理效应。方法：以10头猪为研究对象，其中5头作为对照，5头植入起搏器，起搏180次/次，连续4周诱导非缺血性扩张型心肌病（NIDCM）。两组分别在4个偶联时间间隔内从14个左心室和6个右心室部位送出室性早搏。评估QRS持续时间和血流动力学参数（主动脉流量、dP/dt max和dP/dt min）。结果：两组患者的QRS持续时间均随偶联时间的缩短而增加（对照组：500 ms时为85±7 ms， 350 ms时为93±7 ms）。结论：较短的PVC偶联时间延长QRS持续时间，并使血流动力学恶化，这些影响在扩张型心肌病心脏中更为明显。这可能与LVEF长期下降有关，从而增加发生室性早搏诱发心肌病的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.