Objective A higher premature ventricular complex (PVC) frequency is associated with incident congestive heart failure (CHF) and death. While certain PVC characteristics may contribute to that risk, the current literature stems from patients in medical settings and is therefore prone to referral bias. This study aims to identify PVC characteristics associated with incident CHF in a community-based setting. Methods The Cardiovascular Health Study is a cohort of community-dwelling individuals who underwent prospective evaluation and follow-up. We analysed 24-hour Holter data to assess PVC characteristics and used multivariable logistic and Cox proportional hazards models to identify predictors of a left ventricular ejection fraction (LVEF) decline and incident CHF, respectively. Results Of 871 analysed participants, 316 participants exhibited at least 10 PVCs during the 24-hour recording. For participants with PVCs, the average age was 72±5 years, 41% were women and 93% were white. Over a median follow-up of 11 years, 34% developed CHF. After adjusting for demographics, cardiovascular comorbidities, antiarrhythmic drug use and PVC frequency, a greater heterogeneity of the PVC coupling interval was associated with an increased risk of LVEF decline and incident CHF. Of note, neither PVC duration nor coupling interval duration exhibited a statistically significant relationship with either outcome. Conclusions In this first community-based study to identify Holter-based features of PVCs that are associated with LVEF reduction and incident CHF, the fact that coupling interval heterogeneity was an independent risk factor suggests that the mechanism of PVC generation may influence the risk of heart failure. Data may be obtained from a third party and are not publicly available.

中文翻译：

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社区人群中心室早搏和心力衰竭的发生


目的 较高的室性早搏 (PVC) 频率与发生充血性心力衰竭 (CHF) 和死亡相关。虽然 PVC 的某些特征可能会导致这种风险，但目前的文献来自医疗环境中的患者，因此容易出现转诊偏差。本研究旨在确定社区环境中与 CHF 事件相关的 PVC 特征。方法 心血管健康研究是一组接受前瞻性评估和随访的社区居民。我们分析了 24 小时动态心电图数据来评估 PVC 特征，并使用多变量 Logistic 和 Cox 比例风险模型来分别确定左心室射血分数 (LVEF) 下降和发生 CHF 的预测因子。结果 在 871 名分析参与者中，有 316 名参与者在 24 小时记录期间表现出至少 10 次 PVC。对于患有 PVC 的参与者，平均年龄为 72±5 岁，其中 41% 是女性，93% 是白人。在中位随访 11 年中，34% 的人患上了 CHF。在调整人口统计、心血管合并症、抗心律失常药物使用和室性早搏频率后，室性早搏耦合间隔的较大异质性与 LVEF 下降和发生 CHF 的风险增加相关。值得注意的是，PVC 持续时间和耦合间隔持续时间与任一结果均未表现出统计上显着的关系。结论 在第一项以社区为基础的研究中，旨在确定与 LVEF 降低和发生 CHF 相关的基于动态心电图的 PVC 特征，耦合间隔异质性是一个独立的危险因素，这一事实表明 PVC 的产生机制可能会影响心脏风险失败。数据可能从第三方获得，并且不公开。