Marc Soriano-Amores, Zoraida Moreno-Weidmann, Esther Jorge-Martín, Andreu Ferrero-Gregori, Bieito Campos-Garcia, S Casabella-Ramon, Concepción Alonso-Martín, Enrique Rodríguez-Font, Chi-Hion Li, Xavier Viñolas-Prat, 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-Martín, Andreu Ferrero-Gregori, Bieito Campos-Garcia, S Casabella-Ramon, Concepción Alonso-Martín, Enrique Rodríguez-Font, Chi-Hion Li, Xavier Viñolas-Prat, 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 PVC-induced cardiomyopathy remain unclear.</p><p><strong>Objectives: </strong>To compare the acute physiological effects of PVCs delivered at different coupling intervals and anatomical sites in healthy hearts and in hearts with an established dilated cardiomyopathy.</p><p><strong>Methods: </strong>Ten swine were studied: five served as controls, and five underwent pacemaker implantation with 180 bpm pacing for four weeks to induce non-ischemic dilated cardiomyopathy (NIDCM). PVCs were delivered from 14 left ventricular and 6 right ventricular sites at four coupling intervals in both groups. QRS duration and hemodynamic parameters (aortic flow, dP/dt max and DP/dt min) were assessed.</p><p><strong>Results: </strong>PVC QRS duration increased as coupling interval shortened in both groups (Control: 85±7 ms at 500 ms vs. 93±7 ms at 350 ms, p<0.01; NIDCM: 103±6 ms vs. 119±6 ms, p<0.01). Hemodynamic deterioration paralleled QRS prolongation and was more pronounced in the NIDCM group. PVCs from the left ventricle had greater hemodynamic impact.</p><p><strong>Conclusions: </strong>Shorter PVC coupling intervals prolong QRS duration and worsen hemodynamics, being these effects more pronounced in the dilated cardiomyopathy hearts. This could correlate with a greater long-term decline in the LVEF, 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-Martín, Andreu Ferrero-Gregori, Bieito Campos-Garcia, S Casabella-Ramon, Concepción Alonso-Martín, Enrique Rodríguez-Font, Chi-Hion Li, Xavier Viñolas-Prat, 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 PVC-induced cardiomyopathy remain unclear.</p><p><strong>Objectives: </strong>To compare the acute physiological effects of PVCs delivered at different coupling intervals and anatomical sites in healthy hearts and in hearts with an established dilated cardiomyopathy.</p><p><strong>Methods: </strong>Ten swine were studied: five served as controls, and five underwent pacemaker implantation with 180 bpm pacing for four weeks to induce non-ischemic dilated cardiomyopathy (NIDCM). PVCs were delivered from 14 left ventricular and 6 right ventricular sites at four coupling intervals in both groups. QRS duration and hemodynamic parameters (aortic flow, dP/dt max and DP/dt min) were assessed.</p><p><strong>Results: </strong>PVC QRS duration increased as coupling interval shortened in both groups (Control: 85±7 ms at 500 ms vs. 93±7 ms at 350 ms, p<0.01; NIDCM: 103±6 ms vs. 119±6 ms, p<0.01). Hemodynamic deterioration paralleled QRS prolongation and was more pronounced in the NIDCM group. PVCs from the left ventricle had greater hemodynamic impact.</p><p><strong>Conclusions: </strong>Shorter PVC coupling intervals prolong QRS duration and worsen hemodynamics, being these effects more pronounced in the dilated cardiomyopathy hearts. This could correlate with a greater long-term decline in the LVEF, 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}
Premature Ventricular Contractions on Healthy and Diseased Hearts: Differential Acute Effect of Coupling Interval and Location.
Background: The precise pathophysiological mechanisms underlying PVC-induced cardiomyopathy remain unclear.
Objectives: To compare the acute physiological effects of PVCs delivered at different coupling intervals and anatomical sites in healthy hearts and in hearts with an established dilated cardiomyopathy.
Methods: Ten swine were studied: five served as controls, and five underwent pacemaker implantation with 180 bpm pacing for four weeks to induce non-ischemic dilated cardiomyopathy (NIDCM). PVCs were delivered from 14 left ventricular and 6 right ventricular sites at four coupling intervals in both groups. QRS duration and hemodynamic parameters (aortic flow, dP/dt max and DP/dt min) were assessed.
Results: PVC QRS duration increased as coupling interval shortened in both groups (Control: 85±7 ms at 500 ms vs. 93±7 ms at 350 ms, p<0.01; NIDCM: 103±6 ms vs. 119±6 ms, p<0.01). Hemodynamic deterioration paralleled QRS prolongation and was more pronounced in the NIDCM group. PVCs from the left ventricle had greater hemodynamic impact.
Conclusions: Shorter PVC coupling intervals prolong QRS duration and worsen hemodynamics, being these effects more pronounced in the dilated cardiomyopathy hearts. This could correlate with a greater long-term decline in the LVEF, 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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