Coupling Interval Dispersion and Body Mass Index Are Independent Predictors of Idiopathic Premature Ventricular Complex-Induced Cardiomyopathy
J. E. Olgin reports research support from Zoll and Gilead. E. P. Gerstenfeld reports honoraria for lectures relevant to this topic, but does not specify sponsor(s). Other authors: No disclosures.
Predictors of LV Dysfunction with Idiopathic PVC
Patients with frequent premature ventricular complexes (PVCs) might be at risk for the developing or exacerbation of left ventricular (LV) dysfunction. However, some patients with a high-PVC burden do not develop cardiomyopathy, while other patients with low-PVC burden can develop cardiomyopathy. The purpose of this study was to evaluate the positive predictors of idiopathic PVCs-induced cardiomyopathy.
Methods and Results
We investigated 214 patients undergoing successful ablation of PVCs who had no other causes of cardiomyopathy. We divided the study cohort into 2 groups: ejection fraction (EF) ≥ 50% (normal LV) and EF < 50% (LV dysfunction). We analyzed the clinical characteristics, including the electrocardiogram and findings at electrophysiology study. Among these patients, 51 (24%) had reduced LVEF and 163 (76%) had normal LV function. Patients with LV dysfunction had significantly longer coupling interval (CI) dispersion (maximum-CI–minimum-CI) and had significantly higher PVC burden compared to those with normal LV function (CI-dispersion: 115 ± 25 milliseconds vs. 94 ± 19 milliseconds; P < 0.001; PVC burden: 19% vs. 15%; P = 0.04). Furthermore, patients with LV dysfunction had significantly higher body mass index (BMI) compared to those with normal LV function (BMI > 30 kg/m2; 37% vs. 13%; P = 0.001). Logistic regression analysis showed that CI-dispersion, PVC burden, and BMI (>30 kg/m2) are independent predictors of PVC-induced cardiomyopathy.
In addition to the PVC burden, the CI-dispersion and BMI are associated with PVC-induced cardiomyopathy.