title: Frequent premature ventricular complex is associated with left atrial enlargement in patients with normal left ventricular ejection fraction.
abstract: BACKGROUND
  Premature ventricular complex (PVC) has been regarded as benign; however, when frequent, the arrhythmia can induce left ventricular (LV) systolic dysfunction. Meanwhile, the influence of PVCs on cardiac structural remodeling and functional change before occurrence of overt systolic heart failure has not been fully described. In this study, we attempted to identify early cardiac structural/functional manifestations of frequent PVCs in patients with normal LV systolic function.
  
  
  METHODS
  A total of 146 patients (age: 55 ± 15 years, 48 males) with frequent PVCs observed on 24-hour Holter monitoring (>10/h) and normal LV ejection fraction (LV EF ≥ 55% on echocardiography) were enrolled. Clinical characteristics and echocardiographic parameters of the patients were compared with those of an age-/sex-matched control group (n = 292, age: 55 ± 15 years, 96 males).
  
  
  RESULTS
  Patients with frequent PVCs had significantly larger left atrial volume index (LAVI [28 ± 9 mL/m(2) vs. 24 ± 7 mL/m(2) ]), along with larger LV end-diastolic dimension (49.4 ± 4.4 mm vs. 48.5 ± 3.9 mm), lower LV EF (63 ± 7% vs. 66 ± 6%), and lower peak systolic mitral annular velocity (7 ± 2 cm/s vs. 8 ± 2 cm/s; P < 0.05 for all), whereas other clinical characteristics were similar. In particular, in patients with frequent PVCs, LAVI showed linear correlation with PVC burden (R = 0.30, P < 0.001), and, in a multiple regression model, PVC burden independently estimated LAVI, even after controlling for age, sex, comorbidities, and systolic function (β = 0.309, P < 0.001).
  
  
  CONCLUSIONS
  Frequent PVC is associated with LA enlargement in patients with normal LV EF. Atrial anatomical remodeling may precede LV geometry change and systolic dysfunction in patients with frequent PVCs.
authors.affiliation: Cardiology Division, Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Republic of Korea.
authors.forename: Yeonjeong
authors.initials: Y
authors.lastname: Park
authors.forename: Suji
authors.initials: S
authors.lastname: Kim
authors.forename: Jewook
authors.initials: J
authors.lastname: Shin
authors.forename: Ah Reum
authors.initials: AR
authors.lastname: Oh
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Shin
authors.forename: Jung Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Taehoon
authors.initials: T
authors.lastname: Ahn
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Cha
authors.forename: Jeonggeun
authors.initials: J
authors.lastname: Moon
mesh_terms: D006332:Cardiomegaly / Q000150:complications*; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016277:Ventricular Function, Left; D018879:Ventricular Premature Complexes / Q000150:complications*
keywords: Doppler; echocardiography; left atrium; premature ventricular contraction; remodeling