Prognostic implications of structural heart disease and premature ventricular contractions in recovery of exercise

Figures

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  Figure 1. Flow chart of patient inclusion and exclusion.

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  Figure 2. Time-to-event analysis for the combination of PVCs during recovery and abnormalities on echocardiography among 3106 patients experiencing 219 cardiovascular mortality events during 7.9 [5.4–11.1] years of follow-up. ECHO− no significant abnormality on echocardiography, ECHO+ significant abnormality on echocardiography, PVC premature ventricular contractions, PVC− < 1 PVC/min during recovery, PVC+ ≥ 1 PVC/min during recovery. An echocardiographic abnormality was defined as either: reduced left ventricular ejection fraction, at least moderate valvular heart disease, left ventricular dilatation, increased left ventricular mass, or increased left ventricular filling pressures.

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  Figure 3. Forest plot showing hazard ratios for cardiovascular death with 95% confidence limits (adjusted for age, sex, hypertension, heart failure, ischemic heart disease, diabetes mellitus, body mass index, peak workload, maximal heart rate, maximal systolic blood pressure, heart rate recovery, ST depression, and cardiovascular medications) based on combinations of presence/absence of PVC during recovery and echocardiographic abnormalities. ECHO− no significant abnormality on echocardiography, ECHO+ significant abnormality on echocardiography, PVC premature ventricular contractions, PVC− < 1 PVC/min during recovery, PVC+ ≥ 1 PVC/min during recovery. An echocardiographic abnormality was defined as either: reduced left ventricular ejection fraction, at least moderate valvular heart disease, left ventricular dilatation, increased left ventricular mass or increased filling pressures defined as E/e′ ≥ 15 and either dilated LA or increased RV–RA pressure gradient.

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  Figure 4. Prevalence of echocardiographic abnormalities in patients with PVC during recovery (n = 1327) stratified by cardiovascular (CV) death during follow-up (CV death: n = 138 (red bars); no death: 1189 (light blue bars). ***< 0.001, *< 0.05. Values for echocardiographic measurements within each group can be found in Table 2. LV left ventricular, LVEF left ventricular ejection fraction, LA left atrial, RV right ventricle, RA right atrium. Echocardiographic abnormalities were more common in patients with PVC during recovery and an adverse outcome.