Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure
Abstract Background The clinical significance of premature ventricular complexes (PVCs) in heart failure (HF) remains unclear. We aimed to clarify the associations of PVC burden with re‐hospitalization and cardiac death in HF patients. Methods We studied 435 HF patients (271 men, mean age 65 years)....
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-02-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12259 |
| _version_ | 1818444057778585600 |
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| author | Shinya Yamada Akiomi Yoshihisa Takamasa Sato Masashi Kamioka Takashi Kaneshiro Masayoshi Oikawa Atsushi Kobayashi Takafumi Ishida Yasuchika Takeishi |
| author_facet | Shinya Yamada Akiomi Yoshihisa Takamasa Sato Masashi Kamioka Takashi Kaneshiro Masayoshi Oikawa Atsushi Kobayashi Takafumi Ishida Yasuchika Takeishi |
| author_sort | Shinya Yamada |
| collection | DOAJ |
| description | Abstract Background The clinical significance of premature ventricular complexes (PVCs) in heart failure (HF) remains unclear. We aimed to clarify the associations of PVC burden with re‐hospitalization and cardiac death in HF patients. Methods We studied 435 HF patients (271 men, mean age 65 years). All patients were hospitalized for worsening HF. After optimal medications, echocardiography, 24 hours Holter monitoring and cardiopulmonary exercise testing were performed before discharge. The clinical characteristics and outcomes of the HF patients were investigated. Results During a median follow‐up period of 2.3 years, there were 125 (28.7%) cardiac events (re‐hospitalization due to worsening HF, fatal arrhythmias, or cardiac death). The patients with cardiac events had higher PVC burden compared to those without (median 0.374%/d [interquartile range 0.013‐1.510] vs median 0.026%/d [interquartile range 0.000‐0.534], P < .001). We examined cutoff value of PVC burden for predicting cardiac events. Receiver‐operating characteristic analysis showed PVC burden (>0.145%/d) to be a predictive factor of cardiac events (area under the curve: 0.64). Kaplan‐Meier analysis demonstrated that cardiac events were more frequent in patients with high‐PVC burden (>0.145%/d, n = 194) compared to those with low‐PVC burden (≤0.145%/d, n = 241). Furthermore, the high‐PVC burden patients had left ventricular (LV) and atrial dilatation, reduced LV ejection fraction, and impaired exercise capacity, compared to the low‐PVC burden patients. In Cox proportional hazards analysis, high‐PVC burden was significantly associated with cardiac events with a hazard ratio of 2.028 (95% confidence interval: 1.418‐2.901, P < .001). Conclusion These results suggest that PVC burden is an important predictor of cardiac events in HF patients. |
| first_indexed | 2024-12-14T19:09:53Z |
| format | Article |
| id | doaj.art-2f6cbaeb0c3c46268046644c9b16dea6 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-14T19:09:53Z |
| publishDate | 2020-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-2f6cbaeb0c3c46268046644c9b16dea62022-12-21T22:50:45ZengWileyJournal of Arrhythmia1880-42761883-21482020-02-0136113414210.1002/joa3.12259Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failureShinya Yamada0Akiomi Yoshihisa1Takamasa Sato2Masashi Kamioka3Takashi Kaneshiro4Masayoshi Oikawa5Atsushi Kobayashi6Takafumi Ishida7Yasuchika Takeishi8Department of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanAbstract Background The clinical significance of premature ventricular complexes (PVCs) in heart failure (HF) remains unclear. We aimed to clarify the associations of PVC burden with re‐hospitalization and cardiac death in HF patients. Methods We studied 435 HF patients (271 men, mean age 65 years). All patients were hospitalized for worsening HF. After optimal medications, echocardiography, 24 hours Holter monitoring and cardiopulmonary exercise testing were performed before discharge. The clinical characteristics and outcomes of the HF patients were investigated. Results During a median follow‐up period of 2.3 years, there were 125 (28.7%) cardiac events (re‐hospitalization due to worsening HF, fatal arrhythmias, or cardiac death). The patients with cardiac events had higher PVC burden compared to those without (median 0.374%/d [interquartile range 0.013‐1.510] vs median 0.026%/d [interquartile range 0.000‐0.534], P < .001). We examined cutoff value of PVC burden for predicting cardiac events. Receiver‐operating characteristic analysis showed PVC burden (>0.145%/d) to be a predictive factor of cardiac events (area under the curve: 0.64). Kaplan‐Meier analysis demonstrated that cardiac events were more frequent in patients with high‐PVC burden (>0.145%/d, n = 194) compared to those with low‐PVC burden (≤0.145%/d, n = 241). Furthermore, the high‐PVC burden patients had left ventricular (LV) and atrial dilatation, reduced LV ejection fraction, and impaired exercise capacity, compared to the low‐PVC burden patients. In Cox proportional hazards analysis, high‐PVC burden was significantly associated with cardiac events with a hazard ratio of 2.028 (95% confidence interval: 1.418‐2.901, P < .001). Conclusion These results suggest that PVC burden is an important predictor of cardiac events in HF patients.https://doi.org/10.1002/joa3.12259cardiac deathheart failureHolter monitoringpremature ventricular complexreadmission |
| spellingShingle | Shinya Yamada Akiomi Yoshihisa Takamasa Sato Masashi Kamioka Takashi Kaneshiro Masayoshi Oikawa Atsushi Kobayashi Takafumi Ishida Yasuchika Takeishi Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure Journal of Arrhythmia cardiac death heart failure Holter monitoring premature ventricular complex readmission |
| title | Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure |
| title_full | Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure |
| title_fullStr | Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure |
| title_full_unstemmed | Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure |
| title_short | Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure |
| title_sort | prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure |
| topic | cardiac death heart failure Holter monitoring premature ventricular complex readmission |
| url | https://doi.org/10.1002/joa3.12259 |
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