Premature ventricular complexes and development of heart failure in a community-based population

Worawan B. Limpitikul, Thomas A. Dewland, Eric Vittinghoff, Elsayed Soliman, Gregory Nah, Christina Fang, David S. Siscovick, Bruce M. Psaty, Nona Sotoodehnia, Susan Heckbert, Phyllis K. Stein, John Gottdiener, Xiao Hu, Ralf Hempfling, Gregory M. Marcus

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

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.

Original languageEnglish
Pages (from-to)105-110
Number of pages6
JournalHeart
Volume108
Issue number2
DOIs
StatePublished - Jan 1 2022

Keywords

  • arrhythmias
  • cardiac
  • cardiomyopathies
  • echocardiography
  • heart failure
  • ventricular premature complexes

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