Key result
Frequent PVCs are linked to ~1.6 mL/kg/min lower exercise capacity despite normal LVEF.
Why the study?
Cardiac dysfunction induced by premature ventricular complexes is controversial and challenging to detect in the early stage.
Does cardiopulmonary exercise testing detect early impaired cardiorespiratory capacity (reduced V'O2peak and anaerobic threshold) in patients with frequent premature ventricular complexes (>1,000/24 h) and normal left ventricular ejection fraction compared to matched controls?
Cohort (n=192)
No
Does cardiopulmonary exercise testing detect early impaired cardiorespiratory capacity (reduced V'O2peak and anaerobic threshold) in patients with frequent premature ventricular complexes (>1,000/24 h) and normal left ventricular ejection fraction compared to matched controls?
Cardiopulmonary exercise testing can detect early subclinical impairment in cardiorespiratory capacity (reduced V'O2peak, anaerobic threshold, and ΔV'O2/ΔWR) in patients with frequent PVCs before reductions in left ventricular ejection fraction become apparent on routine echocardiography.
Answers are grounded in this paper and cite their sources.
CPET may detect early cardiorespiratory impairment in frequent PVCs despite normal LVEF; hypothesis-generating and requires prospective validation before clinical adoption.
Cardiac dysfunction induced by premature ventricular complexes (PVCs) is relatively controversial and challenging to detect in the early stage. In this observational study, we retrospectively analyzed the cardiopulmonary exercise test (CPET) data of 94 patients with frequent premature ventricular beats (47 males, 49.83 ± 13.63 years) and 98 participants (55 males, 50.84 ± 9.41 years) whose age and gender were matched with the patient with PVCs. The baseline information and routine echocardiography detection were recorded on admission. PVCs were diagnosed by 24 h Holter monitoring, and cardiorespiratory capacity was assessed using peak oxygen uptake (V’O2peak), anaerobic threshold (AT), and other CPET parameters with an individualized bicycle ramp protocol according to the predicted workload and exercise situation of each participant. There were no statistically significant differences in most baseline characteristics between the two groups. Indicators that reflect cardiopulmonary capacity, such as V’O2peak, AT, and ΔO2 pulse/Δwork rate(ΔV’O2/ΔWR), were all significantly lower in the PVC group (p = 0.031, 0.021, and 0.013, respectively) despite normal and nondiscriminatory left ventricular ejection fractions between the two groups. However, there was no statistically significant difference among subgroups based on the frequency of PVCs, which was <10,000 beats/24 h, 10,000–20,000 beats/24 h, and >20,000 beats/24 h. The cardiorespiratory capacity was lower in patients with frequent PVCs, indicating that CPET could detect early signs of impaired cardiac function induced by PVCs.
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Ma et al. (2023) conducted a cohort in Frequent premature ventricular complexes (PVCs) (n=192). Frequent premature ventricular complexes (>1000 PVCs per 24 h) vs. Age-, gender-, and BMI-matched controls with <1000 PVCs per 24 h was evaluated on Peak oxygen uptake (V'O2peak/kg) (p=0.031). Frequent premature ventricular complexes were associated with lower exercise capacity compared to matched controls despite normal LVEF.
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