Ventricular premature beats and anatomically defined coronary heart disease

Area of Science:

• Cardiology
• Electrophysiology
• Diagnostic Medicine

Background:

• Ambulatory electrocardiographic monitoring is crucial for assessing cardiac arrhythmias.
• Ventricular premature beats (VPBs) are common but their correlation with coronary artery disease (CAD) severity requires further investigation.

Purpose of the Study:

• To evaluate the prevalence and grade of VPBs in patients undergoing cardiac catheterization.
• To determine the relationship between VPBs, coronary artery disease severity, and left ventricular dysfunction.

Main Methods:

• 124 patients underwent 24-hour ambulatory electrocardiographic monitoring prior to cardiac catheterization and coronary angiography.
• VPB prevalence and grade were analyzed in relation to coronary artery disease extent (single-vessel vs. multivessel), left ventricular end-diastolic pressure, and asynergy.
• Repeat monitoring was conducted in a subset of patients to assess reproducibility.

Main Results:

• 83% of all patients exhibited VPBs, with persistence for at least 3 hours in 75% of those with coronary heart disease.
• VPBs were more prevalent and severe in patients with multivessel disease compared to single-vessel disease (P < 0.01).
• Elevated left ventricular end-diastolic pressure and asynergy were associated with increased ventricular ectopy, including ventricular tachycardia and coupled beats (P < 0.005).

Conclusions:

• Ambulatory electrocardiographic monitoring effectively detects VPBs in patients with heart disease.
• VPB prevalence and grade correlate with coronary artery disease severity and left ventricular dysfunction.
• While VPBs can indicate underlying cardiac issues, their individual correlation with disease severity may vary.