Strain Analysis in Patients with Frequent Premature Ventricular Complexes and Preserved Left Ventricular Function...

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Imaging

Background:

• Frequent premature ventricular complexes (PVCs) can cause PVC-induced cardiomyopathy.
• The efficacy of PVC ablation in patients with low-normal ejection fraction (EF) is not well-established.
• Strain analysis offers a sensitive measure of left ventricular function beyond EF.

Purpose of the Study:

• To evaluate the role of PVC ablation in patients with low-normal EF.
• To assess the impact of PVC ablation on EF and myocardial strain.
• To compare outcomes in patients with low-normal versus high-normal EF.

Main Methods:

• Seventy patients with frequent PVCs and either low-normal (50-55%) or high-normal (≥55%) EF were included.
• Ejection fraction (EF) and longitudinal strain were measured before and after successful PVC ablation.
• Patients were stratified into two groups based on baseline EF.

Main Results:

• Successful PVC ablation significantly increased EF (53.2% to 58.3%) and improved longitudinal strain (-15.2 to -16.6) in the low-normal EF group.
• No significant changes in EF or longitudinal strain were observed post-ablation in the high-normal EF group.
• These findings suggest subclinical myocardial dysfunction in patients with low-normal EF and frequent PVCs.

Conclusions:

• Patients with frequent PVCs and low-normal LV EF show evidence of PVC-induced cardiomyopathy.
• PVC ablation may benefit patients with low-normal LV EF and frequent PVCs.
• Strain analysis can detect early myocardial changes indicative of PVC-induced cardiomyopathy.