TY - JOUR
T1 - Premature ventricular complexes and development of heart failure in a community-based population
AU - Limpitikul, Worawan B.
AU - Dewland, Thomas A.
AU - Vittinghoff, Eric
AU - Soliman, Elsayed
AU - Nah, Gregory
AU - Fang, Christina
AU - Siscovick, David S.
AU - Psaty, Bruce M.
AU - Sotoodehnia, Nona
AU - Heckbert, Susan
AU - Stein, Phyllis K.
AU - Gottdiener, John
AU - Hu, Xiao
AU - Hempfling, Ralf
AU - Marcus, Gregory M.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022/1
Y1 - 2022/1
N2 - 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 fac that coupling interval heterogeneity was an independent risk factor suggests that the mechanism of PVC generation may influence the risk of heart failure.
AB - 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 fac that coupling interval heterogeneity was an independent risk factor suggests that the mechanism of PVC generation may influence the risk of heart failure.
UR - http://www.scopus.com/inward/record.url?scp=85122324939&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2021-319473
DO - 10.1136/heartjnl-2021-319473
M3 - Article
C2 - 34493549
AN - SCOPUS:85122324939
SN - 1355-6037
VL - 108
SP - 105
EP - 110
JO - Heart
JF - Heart
IS - 2
ER -