Why the study?
Premature ventricular contractions are frequent in children, but diastolic function had not been investigated to determine if disturbances affect physical performance.
Do premature ventricular contractions impair left ventricular diastolic function and exercise capacity in children with normal systolic function?
Do premature ventricular contractions impair left ventricular diastolic function and exercise capacity in children with normal systolic function?
In children with normal systolic function, premature ventricular contractions are associated with impaired left ventricular diastolic function and decreased exercise capacity.
Diastolic assessment in pediatric PVCs remains hypothesis-generating; prospective data needed before any clinical relevance.
Premature ventricular contractions(PVCs) are frequently seen in children. The diastolic function has not been investigated in PVC children. We evaluated the left ventricular diastolic function in PVC children with normal left ventricular systolic function to detect whether potential diastolic function disturbances influence physical performance. In the study group (36 PVCs children) and the controls (33 healthy volunteers). Echocardiographical diastolic function parameters such as left atrial volume index(LAVI), left atrial strains (AC-R, AC-CT, AC-CD), E wave, E’ medial atrial tissue doppler velocity, E/E’ and isovolumic relaxation time (IVRT) were measured. In the CPET, oxygen uptake (VO2max) was registered. Evaluation of diastolic function parameters revealed statically significant differences between the study and control group regarding Edt 176.58 ± 54.8ms vs 136.94 ± 27.8ms,p < 0.01; E/E’12.6 ± 3.0 vs. 6.7 ± 1.0,p < 0.01; IVRT 96.6 ± 19.09ms. vs. 72.86 ± 13.67 ms,p < 0.01, respectively. Left atrial function was impaired in the study group compared to controls: LAVI 25.3 ± 8.2ml/m 2 vs. 19.2 ± 7.5ml/m 2 ,p < 0.01, AC-CT 34.8 ± 8.6% vs. 44.8 ± 11.8%,p < 0.01; AC-R-6.0 ± 4.9% vs. -11.5 ± 3.5%, p < 0.01, respectively. Statistically significant moderate, negative correlation between VO2max and E/E’(r =-0.33, p = 0.02) was found. Left ventricular diastolic function is impaired and deteriorates with the arrhythmia burden increase in PVC children. Ventricular arrhythmia in young individuals may be related to the filling pressure elevation and drive to exercise capacity deterioration.
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Pietrzak et al. (2023) studied this question.
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