Key result
Risk factors including non-sustained VTs (OR 3.01), epicardial origin (OR 4.72), interpolation (OR 4.93), and PVC burden (OR 1.06) were significantly associated with PVC-induced cardiomyopathy.
Why the study?
Premature ventricular complexes can cause reversible heart failure, but the risk factors contributing to the development of impaired left ventricular function remain unclear.
What risk factors are associated with the development of PVC-induced cardiomyopathy in patients with premature ventricular complexes?
Meta-Analysis (n=16,764,641)
What risk factors are associated with the development of PVC-induced cardiomyopathy in patients with premature ventricular complexes?
Odds Ratio: 1.06 (95% CI 1.04–1.08)
Age, non-sustained VTs, LV and epicardial origin, interpolation, and PVC burden are consistent risk factors for PVC-induced cardiomyopathy, whereas the presence of symptoms is associated with a lower risk.
Supports monitoring high-risk PVC patients to prevent cardiomyopathy; confirms consistent predictors across studies.
Background Premature ventricular complexes (PVCs) can be a reversible cause of heart failure. To date, it is unclear which risk factors contribute to the development of impaired left ventricular function. Objective Systematically assessing risk factors for the development of PVC-induced cardiomyopathy (PVC-CM). Methods We performed a structured database search of the scientific literature for studies investigating risk factors for the development of PVC-induced Cardiomyopathy. We investigated the reporting of PVC-induced Cardiomyopathy risk factors (RF) and assessed the comparative association of the different RF using random-effect meta-analysis. Results A total of 26 studies (9 prospective and 17 retrospective studies) involving 16.764.641 patients were analyzed (mean age 55 y, 58% women, mean PVC burden 17%). Suitable for quantitative analysis were 25 studies examining 6738 (0.04%) patients and 11 RF (≥3 occurrences in multivariable model assessing a binary change in left ventricular - LV- function). Among these risk factors, age (OR 1.02 per increase in the year of age, 95%-CI [1.01, 1.02]), the presence of symptoms (OR 0.18, 95%-CI [0.05, 0.64]), non-sustained VTs (OR 3.01, 95%-CI [1.39, 6.50]), LV origin (OR 2.20, 95%-CI [1.14, 4.23]), epicardial origin (OR 4.72, 95%-CI [1.81, 12.34]), the presence of interpolation - PVCs that do not reset the RR interval (OR 4.93, 95%-CI [1.66, 14.69]) and overall PVC burden (OR 1.06, 95%-CI [1.04, 1.08]) were all significantly associated with PVC-induced Cardiomyopathy. (Figures 1,2) Conclusion In this meta-analysis, the most consistent risk factors for PVC-CM were age, non-sustained VTs, LV and epicardial origin, interpolation, and PVC burden, while the presence of symptoms significantly reduced the risk. These findings help tailor stringent follow-up to patients presenting with frequent PVCs and normal LV function. Funding Acknowledgement Type of funding sources: None.
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Serban et al. (2022) conducted a meta-analysis in Premature ventricular complex-induced cardiomyopathy (n=16,764,641). Risk factors (e.g., PVC burden, non-sustained VTs, epicardial origin) was evaluated on Development of PVC-induced cardiomyopathy (OR 1.06, 95% CI 1.04-1.08). Risk factors including non-sustained VTs (OR 3.01), epicardial origin (OR 4.72), interpolation (OR 4.93), and PVC burden (OR 1.06) were significantly associated with PVC-induced cardiomyopathy.
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