Key result
ACEI or ARB use is linked to greater PVC reduction and improved LVEF in non-ischemic patients.
Why the study?
Does medical therapy, particularly ACEI/ARB, reduce PVC burden in patients with non-ischemic heart disease and frequent PVCs?
Cohort (n=86)
Does medical therapy, particularly ACEI/ARB, reduce PVC burden in patients with non-ischemic heart disease and frequent PVCs?
p-value: p=<0.05
In patients with non-ischemic heart disease and frequent PVCs, treatment with ACEI/ARB or beta-blockers is associated with a significant reduction in PVC burden and improvement in ejection fraction.
May support ACEI/ARB for PVC reduction in non-ischemic disease; leaves open causal confirmation by RCTs.
There are few long‐term reports of patients with frequent PVCs in the absence of ischemic heart disease. In 86 patients without ischemic heart disease, who had 1000 or more PVCs in 24‐hour Holter ECG, the number of PVCs during 24‐hours Holter ECG and echocardiographic parameters were followed at least 1 year (66.5 ± 39.7 months). PVC was significantly reduced in the patients with or without underlying diseases (UD). The reduction rate in the number of PVCs was prominent in patients with UD. PVC was significantly reduced in patients under medication, but not in patients without medication. In the comparison between the initial and follow up observation using Wilcoxon's rank test, the number of PVC was significantly reduced (P < 0.05), and EF was also improved (P < 0.05) in angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) group, and in β‐blocker group. In Ca‐antagonist group and antiarrhythmic drug group, the number of PVCs was also significantly reduced (P < 0.05). Multivariate analysis revealed significantly higher incidence (60% or more with PVC reduction) in ACEI/ARB group. These results suggest that the administration of ACEI/ARB may contribute to the reduction of PVC in non‐ischemic heart disease cases with multiple PVC.
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Komoriya et al. (2008) conducted a cohort in Non-ischemic heart disease with premature ventricular contraction (n=86). ACEI or ARB vs. No medication or other medications was evaluated on Reduction in the number of PVCs (p=<0.05). ACEI or ARB therapy was associated with a significantly higher incidence of PVC reduction (60% or more) and improved ejection fraction (P<0.05) in patients with non-ischemic heart disease.
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