title: Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor.
abstract: Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P<0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P<0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Wenhua
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Mingfang
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Minglong
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Bing
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Daowu
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Xiangqing
authors.initials: X
authors.lastname: Kong
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Hongwu
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Weizhu
authors.initials: W
authors.lastname: Ju
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Kai
authors.initials: K
authors.lastname: Gu
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Kejiang
authors.initials: K
authors.lastname: Cao
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Hailei
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Qi
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Jiaojiao
authors.initials: J
authors.lastname: Shi
authors.affiliation: Nursing College of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Yan
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Respiratory, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China .
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
keywords: burden; left ventricular function; origin sites; premature ventricular contractions