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The influence of premature ventricular contractions on left ventricular function in asymptomatic children without structural heart disease: an echocardiographic evaluation

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Abstract

Background: Isolated monomorphic premature ventricular contractions (PVCs) are not uncommon in the pediatric population. The degree of cardiac dysfunction caused by PVCs in children without structural heart disease is unknown. Purpose: To investigate the influence of PVCs on echocardiographic left ventricular (LV) systolic function in children without structural heart disease. Methods: Forty asymptomatic children with isolated monomorphic PVCs without structural heart disease were selected. The median age was 6 years, range of 3–12 years. The following subgroups were compared: frequent vs. infrequent PVCs (> or ≤10/min); short vs. long coupling interval (RR′/RR ratio ≤ or >0.6); and short vs. long QT interval (QT ≤ or >400 ms). Using echocardiography the left ventricular ejection fraction (LVEF in percentage) and cardiac index (CI in L/min/m2) were measured for both normal sinus beats (SB-LVEF and CI), PVCs (PVC-LVEF and CI) and the average LVEF and CI were calculated. All values were expressed as means ± SD. Results: In all children LV dimensions and the SB-LVEF and CI were within normal limits. The PVC-LVEF (48 ± 5) and PVC-CI (1.57 ± 0.19) were significantly decreased and the average CI was 2.41 ± 0.29. In 27 pts with >10 PVCs/min the average LVEF and CI decreased to 53 ± 5 and 2.08 ± 0.24 respectively. In 16 pts with PVCs and a short coupling interval (RR′/RR ≤ 0.6) the PVC-LVEF and PVC-CI was 43 ± 0.03 and 1.50 ± 0.14, which was significantly lower than in 24 pts with a long coupling interval (58 ± 4, 1.88 ± 0.11). In 11 pts with a prolonged QT interval (>400 ms) the PVC-LVEF and PVC-CI was significantly lower than in the 29 children with a shorter QT interval, 41 ± 5 vs. 55 ± 4 and 1.46 ± 0.13 vs. 1.86 ± 0.15 respectively (all p < 0.01). Conclusion: In asymptomatic children with isolated monomorphic PVCs the average ejection fraction and cardiac output is markedly reduced if PVCs are frequent (>10/min), have a short coupling interval or a prolonged QT interval.

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Authors and Affiliations

  1. Shandong Provincial Hospital, Jinan, 250021, PR China

    Yiping Sun, Yonghui Yu, Peiran Ma, Yi Wang & Xiuzhen Han

  2. Department of Pediatric Cardiology and Cardiology, Leiden University Medical Center, The Netherlands

    Yiping Sun, Nico A. Blom, Cees A. Swenne & Ernst E. van der Wall

Authors
  1. Yiping Sun
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  2. Nico A. Blom
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  3. Yonghui Yu
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  4. Peiran Ma
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  5. Yi Wang
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  6. Xiuzhen Han
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  7. Cees A. Swenne
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  8. Ernst E. van der Wall
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Sun, Y., Blom, N.A., Yu, Y. et al. The influence of premature ventricular contractions on left ventricular function in asymptomatic children without structural heart disease: an echocardiographic evaluation. Int J Cardiovasc Imaging 19, 295–299 (2003). https://doi.org/10.1023/A:1025418531853

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  • DOI: https://doi.org/10.1023/A:1025418531853

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