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Evaluation of left ventricular diastolic functions in patients with frequent premature ventricular contractions from right ventricular outflow tract

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Abstract

This study was sought to examine the effects of repetitive monomorphic premature ventricular contractions (PVCs) on left ventricular (LV) diastolic function. Thirty-three symptomatic patients (Study group, 10 males, mean age 40 ± 8 years) with normal LV systolic function and repetitive PVCs originating from the right ventricular outflow tract (RVOT-PVCs) on 24-h Holter monitoring, and 30 healthy controls (Control group, 9 males, mean age 37 ± 9 years) were enrolled in the study. None of the patients had structural heart disease. Diastolic function was assessed by echocardiographic mitral inflow pattern and tissue Doppler imaging. The study group displayed a lower E/A ratio, longer isovolumetric relaxation time (IVRT), and longer E-wave deceleration time (EDT). In the study group 13 patients showed impaired relaxation. While mean values of the systolic velocity (Sa), early diastolic velocity (Ea), and early/late diastolic velocity (Ea/Aa) ratio were significantly lower in the study group, the Aa velocity and E/Ea ratio were significantly higher. Ea velocity was <10 cm/s in 7 study patients. Mitral inflow pattern and Ea velocity was normal in all controls. Significant correlations were found between ventricular premature beats percentage and early to late transmitral flow velocity ratio, EDT, IVRT, Ea velocity, the Ea/Aa ratio, and the E/Ea ratio. In multivariate analysis, total PVC count and age were found to be independent predictors of impaired relaxation. These results suggest that repetitive monomorphic RVOT-PVCs lead to abnormalities of LV diastolic function that may contribute to clinical symptoms in patients with structurally normal hearts.

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References

  1. W Grimm V Menz J Hoffmann B Maisch (2001) ArticleTitleReversal of tachycardia induced cardiomyopathy following ablation of repetitive monomorphic right ventricular outflow tract tachycardia Pacing Clin Electrophysiol 24 166–171 Occurrence Handle11270695 Occurrence Handle10.1046/j.1460-9592.2001.00166.x Occurrence Handle1:STN:280:DC%2BD3M7nsFeruw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. Z Wang WD Denney LK Taylor DM Regen DE Hansen (1995) ArticleTitleMechanical characteristics of tachycardia-induced left-ventricular failure as evaluated in isolated dog hearts Heart Vessels 10 IssueID1 12–23 Occurrence Handle7730243 Occurrence Handle10.1007/BF01745073 Occurrence Handle1:STN:280:DyaK2M3kslKntw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  3. DF Duffee WK Shen HC Smith (1998) ArticleTitleSuppression of frequent premature ventricular contractions and improvement of left ventricular function in patients with presumed idiopathic dilated cardiomyopathy Mayo Clin Proc 73 430–433 Occurrence Handle9581582 Occurrence Handle1:STN:280:DyaK1c3ktVKmug%3D%3D Occurrence Handle10.4065/73.5.430

    Article  PubMed  CAS  Google Scholar 

  4. RK Yarlagadda S Iwai KM Stein SM Markowitz BK Shah JW Cheung V Tan BB Lerman S Mittal (2005) ArticleTitleReversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract Circulation 112 1092–1097 Occurrence Handle16103234 Occurrence Handle10.1161/CIRCULATIONAHA.105.546432

    Article  PubMed  Google Scholar 

  5. M Takemoto H Yoshimura Y Ohba Y Matsumoto U Yamamoto M Mohri H Yamamoto H Origuchi (2005) ArticleTitleRadiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease J Am Coll Cardiol 45 1259–1265 Occurrence Handle15837259 Occurrence Handle10.1016/j.jacc.2004.12.073

    Article  PubMed  Google Scholar 

  6. Y Sekiguchi K Aonuma Y Yamauchi T Obayashi A Niwa H Hachiya A Takahashi J Nitta Y Iesaka M Isobe (2005) ArticleTitleChronic hemodynamic effects after radiofrequency catheter ablation of frequent monomorphic ventricular premature beats J Cardiovasc Electrophysiol 16 1057–1063 Occurrence Handle16191115 Occurrence Handle10.1111/j.1540-8167.2005.40786.x

    Article  PubMed  Google Scholar 

  7. MA Quinones CM Otto M Stoddard A Waggoner WA Zoghbi (2002) ArticleTitleRecommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography J Am Soc Echocardiogr 15 167–184 Occurrence Handle11836492 Occurrence Handle10.1067/mje.2002.120202

    Article  PubMed  Google Scholar 

  8. NP Nikitin KK Witte SD Thackray R de Silva AL Clark JG Cleland (2003) ArticleTitleLongitudinal ventricular function: normal values of atrioventricular annular and myocardial velocities measured with quantitative two-dimensional color Doppler tissue imaging J Am Soc Echocardiogr 16 906–921 Occurrence Handle12931102 Occurrence Handle10.1016/S0894-7317(03)00279-7

    Article  PubMed  Google Scholar 

  9. How to diagnose diastolic heart failure. European Study Group on Diastolic Heart Failure. Eur Heart J 1998;19:990–1003

    Google Scholar 

  10. MS Firstenberg BD Levine MJ Garcia NL Greenberg L Cardon AJ Morehead J Zuckerman JD Thomas (2000) ArticleTitleRelationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers J Am Coll Cardiol 36 1664–1669 Occurrence Handle11079674 Occurrence Handle10.1016/S0735-1097(00)00909-8 Occurrence Handle1:STN:280:DC%2BD3M%2FnsVGktw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. C Rivas-Gotz M Manolios V Thohan SF Nagueh (2003) ArticleTitleImpact of left ventricular ejection fraction on estimation of left ventricular filling pressures using tissue Doppler and flow propagation velocity Am J Cardiol 91 780–784 Occurrence Handle12633827 Occurrence Handle10.1016/S0002-9149(02)03433-1

    Article  PubMed  Google Scholar 

  12. SJ Khouri GT Maly DD Suh TE Walsh (2004) ArticleTitleA practical approach to the echocardiographic evaluation of diastolic function J Am Soc Echocardiogr 17 290–297 Occurrence Handle14981433 Occurrence Handle10.1016/j.echo.2003.08.012

    Article  PubMed  Google Scholar 

  13. JK Oh CP Appleton LK Hatle RA Nishimura JB Seward AJ Tajik (1997) ArticleTitleThe noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography J Am Soc Echocardiogr 10 246–270 Occurrence Handle9109691 Occurrence Handle10.1016/S0894-7317(97)70062-2 Occurrence Handle1:STN:280:DyaK2s3mtlOktA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  14. L Littmann JD Symanski (2000) ArticleTitleHemodynamic implications of left bundle branch block J Electrocardiol 33 IssueIDSuppl 115–121 Occurrence Handle11265710 Occurrence Handle10.1054/jelc.2000.20330

    Article  PubMed  Google Scholar 

  15. C Bruch J Stypmann M Grude R Gradaus G Breithardt T Wichter (2006) ArticleTitleLeft bundle branch block in chronic heart failure-impact on diastolic function, filling pressures, and B-type natriuretic peptide levels J Am Soc Echocardiogr 19 95–101 Occurrence Handle16423676 Occurrence Handle10.1016/j.echo.2005.07.006

    Article  PubMed  Google Scholar 

  16. J Nothroff K Norozi V Alpers JO Arnhold A Wessel W Ruschewski R Buchhorn (2006) ArticleTitlePacemaker implantation as a risk factor for heart failure in young adults with congenital heart disease Pacing Clin Electrophysiol 29 386–392 Occurrence Handle16650267 Occurrence Handle10.1111/j.1540-8159.2006.00358.x

    Article  PubMed  Google Scholar 

  17. H Shiraishi K Ishibashi N Urao M Tsukamoto M Hyogo N Keira S Hirasaki T Shirayama M Nakagawa (2002) ArticleTitleA case of cardiomyopathy induced by premature ventricular complexes Circ J 66 1065–1067 Occurrence Handle12419942 Occurrence Handle10.1253/circj.66.1065

    Article  PubMed  Google Scholar 

  18. DE Hansen GT Daughters Suffix2nd EL Alderman NB Ingels SuffixJr DC Miller (1988) ArticleTitleTorsional deformation of the left ventricular midwall in human hearts with intramyocardial markers: regional heterogeneity and sensitivity to the inotropic effects of abrupt rate changes Circ Res 62 941–952 Occurrence Handle3282715 Occurrence Handle1:STN:280:DyaL1c7psV2hsQ%3D%3D

    PubMed  CAS  Google Scholar 

  19. HB Xiao CH Lee DG Gibson (1991) ArticleTitleEffect of left bundle branch block on diastolic function in dilated cardiomyopathy Br Heart J 66 443–447 Occurrence Handle1772710 Occurrence Handle1:STN:280:DyaK387is1Cisw%3D%3D

    PubMed  CAS  Google Scholar 

  20. MG St John Sutton T Plappert WT Abraham AL Smith DB DeLurgio AR Leon E Loh DZ Kocovic WG Fisher M Ellestad J Messenger K Kruger KE Hilpisch MR Hill (2003) ArticleTitleEffect of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure Circulation 107 1985–1990 Occurrence Handle12668512 Occurrence Handle10.1161/01.CIR.0000065226.24159.E9

    Article  PubMed  Google Scholar 

  21. AD Waggoner MN Faddis MJ Gleva L de las Fuentes VG Davila-Roman (2005) ArticleTitleImprovements in left ventricular diastolic function after cardiac resynchronization therapy are coupled to response in systolic performance J Am Coll Cardiol 46 2244–2249 Occurrence Handle16360053 Occurrence Handle10.1016/j.jacc.2005.05.094

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Türkiye Yuksek Ihtisas Hospital, Ankara, Turkey

    Serkan Topaloglu, Dursun Aras, Kumral Cagli, Ali Yıldız, Goksel Cagirci, Serkan Cay, Emre Nuri Gunel, Kazim Baser, Erkan Baysal, Ayca Boyaci & Sule Korkmaz

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  1. Serkan Topaloglu
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  2. Dursun Aras
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  3. Kumral Cagli
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  5. Goksel Cagirci
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Correspondence to Serkan Topaloglu.

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Topaloglu, S., Aras, D., Cagli, K. et al. Evaluation of left ventricular diastolic functions in patients with frequent premature ventricular contractions from right ventricular outflow tract. Heart Vessels 22, 328–334 (2007). https://doi.org/10.1007/s00380-007-0978-9

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  • DOI: https://doi.org/10.1007/s00380-007-0978-9

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