Speckle Tracking Versus Conventional Echocardiography in Patients with Symptomatic Premature Ventricular Contractions

Background:Frequent premature ventricular complexes [PVCs] are linked to the left ventricular [LV] dysfunction. Early diagnosis is crucial for the proper treatment. Aim of the Work:This study aimed to prove the superiority of modern diagnostic modalities as speckle tracking over the conventional echocardiography in the detection of subtle left ventricular dysfunction in symptomatic PVCs. Patients and Methods:This study included 40 patients with frequent PVCs and 20 healthy subjects, as a comparison group. The myocardium strain in the circumferential [CS], radial [R] and longitudinal [L] directions were evaluated using conventional echocardiography and speckle tracking imaging. Result:The study included 21 male and 39 females with age ranging between 22 and 56 years in the study group and between 22 and 57 years in the control group. In the case group, PVCs were more frequent [18.73 ± 7.15]. The two groups have normal resting conventional echocardiography with no evidence of structural heart or systemic disease. In the study group, 25 patients have PVCs arising from the right ventricle [RV] [62.5%] and 15 patients have PVCs arising from the LV [37.5%]. There was no significant correlation between PVCs origin and LV global longitudinal strain [GLS], radial strain [RS] and circumferential strain [CS] [p value= 0.285, 0.380 and 0.401] respectively. There was a significant inverse correlation between the total number of PVCs [PVC burden] and LV ejection fraction [EF], GLS, RS, and CS [p value <0.001]. Conclusion: The study concluded that speckle tracking echocardiography is an important and valuable tool for early identification of impairment in the LV function in patients with frequent PVCs earlier than conventional echocardiogram.