Exercise-Related Ventricular Premature Complexes in Coronary Heart Disease

This study correlates the presence of exercise-related ventricular premature complexes with both exercise-induced ST-segment depression and coronary arteriographic and ventriculographic findings in 60 patients evaluated for chest pain. Of 38 patients in whom ventricular premature complexes were either precipitated or increased with exercise, 22 had coronary disease, 10 showed a cardiomyopathy, and 6 were normal. Twelve of the 22 coronary patients had 3-vessel disease, 6 had 2-vessel disease and 4 had 1-vessel disease. Sixteen of these 22 also showed coronary collaterals and left ventricular contraction abnormalities (asynergy). Twenty of the 22 showed ≥2 mm ST-segment depression with exercise, in addition to the ventricular premature complexes (P < 0.001). Twenty-two patients showed a decrease in ventricular premature complexes with exercise. Six had coronary disease, eight had a cardiomyopathy, and eight were normal. None of the six with coronary disease had 3-vessel disease, two had 2-vessel disease, and four had disease of 1 vessel. Collaterals and asynergy were found in one of the six patients. None of the patients in this group showed ST-segment depression with exercise.