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
{"title":"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。","authors":"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","doi":"10.1016/j.hrthm.2025.09.035","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The precise pathophysiological mechanisms underlying premature ventricular contraction (PVC)-induced cardiomyopathy remain unclear.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Premature ventricular contractions on healthy and diseased hearts: Differential acute effect of coupling interval and location.\",\"authors\":\"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\",\"doi\":\"10.1016/j.hrthm.2025.09.035\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The precise pathophysiological mechanisms underlying premature ventricular contraction (PVC)-induced cardiomyopathy remain unclear.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":12886,\"journal\":{\"name\":\"Heart rhythm\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2025-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart rhythm\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hrthm.2025.09.035\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2025.09.035","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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.
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.
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