Premature ventricular complexes and development of heart failure in a community-based population
- 7 September 2021
- Vol. 108 (2), 105-110
- https://doi.org/10.1136/heartjnl-2021-319473
Abstract
Objective A higher premature ventricular complex (PVC) frequency is associated with incident congestive heart failure (CHF) and death. While certain PVC characteristics may contribute to that risk, the current literature stems from patients in medical settings and is therefore prone to referral bias. This study aims to identify PVC characteristics associated with incident CHF in a community-based setting. Methods The Cardiovascular Health Study is a cohort of community-dwelling individuals who underwent prospective evaluation and follow-up. We analysed 24-hour Holter data to assess PVC characteristics and used multivariable logistic and Cox proportional hazards models to identify predictors of a left ventricular ejection fraction (LVEF) decline and incident CHF, respectively. Results Of 871 analysed participants, 316 participants exhibited at least 10 PVCs during the 24-hour recording. For participants with PVCs, the average age was 72±5 years, 41% were women and 93% were white. Over a median follow-up of 11 years, 34% developed CHF. After adjusting for demographics, cardiovascular comorbidities, antiarrhythmic drug use and PVC frequency, a greater heterogeneity of the PVC coupling interval was associated with an increased risk of LVEF decline and incident CHF. Of note, neither PVC duration nor coupling interval duration exhibited a statistically significant relationship with either outcome. Conclusions In this first community-based study to identify Holter-based features of PVCs that are associated with LVEF reduction and incident CHF, the fact that coupling interval heterogeneity was an independent risk factor suggests that the mechanism of PVC generation may influence the risk of heart failure.Keywords
Funding Information
- RRF
- CHS
- National Heart, Lung, and Blood Institute
- University of California, San Francisco (75N92021D00006, HHSN268200800007C, HHSN268201200036C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, U01HL080295, U01HL130114)
- National Institute on Aging (R01AG023629)
- National Institute of Neurological Disorders and Stroke
This publication has 32 references indexed in Scilit:
- Irregular Rhythm Adversely Influences Calcium Handling in Ventricular MyocardiumCirculation: Heart Failure, 2012
- Prediction of Incident Heart Failure in General PracticeCirculation: Heart Failure, 2012
- Characteristics of Premature Ventricular Complexes as Correlates of Reduced Left Ventricular Systolic Function: Study of the Burden, Duration, Coupling Interval, Morphology and Site of Origin of PVCsJournal of Cardiovascular Electrophysiology, 2011
- Assessment of Conventional Cardiovascular Risk Factors and Multiple Biomarkers for the Prediction of Incident Heart Failure and Atrial FibrillationJournal of the American College of Cardiology, 2010
- Prognostic significance of frequent premature ventricular contractions originating from the ventricular outflow tract in patients with normal left ventricular functionHeart, 2009
- Electrocardiographic markers of structural heart disease and predictors of death in 2332 unselected patients undergoing outpatient Holter recordingEP Europace, 2007
- Left Ventricular Dysfunction in Atrial Fibrillation: Restoration of Sinus Rhythm by the Cox-Maze Procedure Significantly Improves Systolic Function and Functional StatusThe Annals of Thoracic Surgery, 2006
- Assessment of the variability in coupling intervales of ventricular premature contractions.Japanese Circulation Journal, 1993
- Assessing the use of medications in the elderly: Methods and initial experience in the cardiovascular health studyJournal of Clinical Epidemiology, 1992
- The cardiovascular health study: Design and rationaleAnnals of Epidemiology, 1991