Risk Factors for Left Ventricle Enlargement in Children With Frequent Ventricular Premature Complexes

Chen, Bin; Li, Jiaoyu; Li, Shujing; Fang, Yong; Zhao, Pei

doi:10.1016/j.amjcard.2020.06.042

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…In this study, clinical characteristics, Holter monitoring, and HRV were systematically considered in the predictive risk factor of LV enlargement in patients with frequent PVCs by univariate and multivariate analyses. On multivariate analysis, the Holter monitoring parameter of high PVC burden had a greater risk of LV enlargement in patients with frequent PVCs, and this also accords with a recent observation, which showed that high PVC burden was the risk factor for LV enlargement in children with frequent idiopathic PVCs [41]. Meanwhile, time-domain variables including increased sympathetic parameters SDNN and decreased parasympathetic parameters pNN50 were also considered risk factors for LV enlargement in patients with frequent PVCs.…”

Section: Discussionsupporting

confidence: 86%

Risk Factors and Heart Rate Variability Associated with Left Ventricular Enlargement in Patients with Frequent Premature Ventricular Contractions

et al. 2022

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Introduction: Premature ventricular contractions (PVCs) were now well recognized to carry the risk of inducing left ventricular (LV) enlargement and were closely related to the cardiac autonomic nervous activity quantified by heart rate variability (HRV) analysis. However, the relationship between LV enlargement and HRV in patients with frequent PVCs is still unclear. This study aimed to investigate the risk factors and HRV for LV enlargement in patients with Frequent PVCs. Methods: Patients with frequent PVCs (n=571), whose PVC burden counts > 10000/24h or PVC burden > 10%, were recruited. Patients were divided into LV enlargement group (n=161), defined as female left ventricular end-diastolic diameter (LVEDD) > 49.8 mm or male LVEDD > 54.2 mm, and LV normal group (n=410). Two groups were compared on their clinical, electrocardiographic, and HRV parameters. Logistic regression analysis was used to predict the risk factors of LV enlargement in patients with frequent PVCs. The parameters of echocardiography, Holter monitoring, and HRV were collected after ablation. Results: There were significant differences between the patients with left enlargement and with normal LV structure, in terms of sex, left ventricular ejection fraction (LVEF), level of N-terminal pro-brain natriuretic peptide (NT-proBNP), 24-h PVCs burden, with non-sustained ventricular tachycardia, multifocal PVCs, QRS duration of PVC and values of very low-frequency power of HRV parameter (all p<0.05). Multivariate analysis showed that female gender (odds ratio (OR)=2.753, p<0.001), increased NT-proBNP (OR=1.011, p=0.022), increased LVEF (OR=0.292, p<0.001), increased 24-hour PVCs burden (OR=1.594, p<0.001), increased standard deviation of all NN intervals (SDNN) (OR=1.100, p=0.003), increased the proportion of consecutive NN intervals that differ by more than 50ms (PNN50) (OR=0.844, p=0.026) were predictors for LV enlargement in patients with frequent PVCs. 84.4% (54/64) of patients with LV enlargement at baseline had normalized their LV structure after ablation. The values of SDNN, standard deviation of the averages of NN intervals in all 5-min segments, the square root of the mean of the sum of the squares of differences between adjacent NN intervals, pNN50, low-frequency power (LF), LF/high-frequency power ratio of patients were significantly decreased after ablation (all p<0.05). Conclusion: female gender, increased level of NT-proBNP, lower LVEF, higher PVC burden, the increased sympathetic parameters SDNN, and reduced parasympathetic parameters PNN50 were the independent risk factors of LV enlargement in patients with frequent PVCs. LV enlargement induced by PVCs can be reversible after PVC elimination by ablation. The activities of sympathetic and parasympathetic were reduced after ablation.

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Section: Discussionsupporting

confidence: 86%

Risk Factors and Heart Rate Variability Associated with Left Ventricular Enlargement in Patients with Frequent Premature Ventricular Contractions

et al. 2022

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“…Data from different authors have shown that between 23% and 48.5% of children with VE experience somatic symptoms [4,21,22], such as palpitations, fainting, fatigue, chest pain, or syncope [22]. In our study, 45% of the children had symptoms.…”

Section: Discussionsupporting

confidence: 42%

“…It is estimated that 18-50% of healthy children have VE detected on ambulatory monitors [3]. Although idiopathic ventricular extrasystoles in children are considered benign, about one-third of patients Medicina 2024, 60, 213. https://doi.org/10.3390/medicina60020213 https://www.mdpi.com/journal/medicina experience somatic symptoms [4] and face limitations in physical activity. The identification of VE and its potential impact on fitness for sport is a frequent topic of debate involving physicians from different specialties [5].…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Depression Symptoms and Physical Activity in Children with Idiopathic Ventricular Extrasystoles

Kunigeliene,

Kinciniene,

Usonis

et al. 2024

Medicina

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Background and Objectives: Depression in childhood often co-occurs with anxiety disorders and a range of somatic symptoms. Recent studies have identified physical activity as a target for preventing the onset of depression. However, idiopathic ventricular extrasystoles (VEs) in children are sometimes associated with somatic symptoms and limitations in physical activity. The occurrence of arrhythmia can also be distressing for children and their parents. This study was conducted to determine the relationship between symptoms of depression, physical activity, and somatic symptoms in children with idiopathic VE. Materials and Methods: This study of children with structurally normal hearts and VE was approved by the local ethics committee (no. 2021/10-1383˗859(1). The authors designed a questionnaire to assess symptoms, physical activity, and general well-being. As part of that, symptoms of depression were evaluated with a modified pediatric PHQ-9 (MP-PHQ-9) questionnaire, with scores ≤4 for no, 5–9 for mild, 10–14 for moderate, and ≥15 for severe depression. Children aged ≥12 years and parents who assessed their children’s condition completed the questionnaires. All children also underwent 24-h electrocardiography and echocardiography to evaluate arrhythmia frequency and cardiac condition. Results: Questionnaires were completed by 60 children’s parents and 39 children (≥12 years old). The median children’s age was 13 years. Palpitations were experienced by 26 (43.3%), chest pain by 13 (21.7%), and exercise intolerance by 15 (25%) children. All patients had normal ventricular function and hemodynamically normal hearts. The median score of the MP-PHQ-9 completed by parents was 2, and by children was 4. The median VE frequency was 4.77 (0.1–32.77) % per 24 h. We found that 31 (51.7%) children engaged in extra-sports participation with a median time of 3.75 h per week. Eleven of the children were suspended from sports. There was no significant difference between VE frequency and MP-PHQ-9 scores. Higher MP-PHQ-9 scores were noted for symptomatic children who engaged in <5 h per week of physical activity. Conclusions: Higher depression scores were found for children with somatic symptoms than those without symptoms. Children who were physically active for less than 5 h per week also had higher depression risk scores than those who were more active. Our research has shown that parents underestimate the signs of depression in their children.

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High Burden Ventricular Ectopy > 10% in Children with Structurally Normal Hearts: Investigating the Association of Ventricular Ectopy Frequency, Holter and ECG Findings, and Ventricular Dysfunction

Aldrich,

Daniels,

Eisner

et al. 2024

Pediatr Cardiol

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Risk Factors for Left Ventricle Enlargement in Children With Frequent Ventricular Premature Complexes

Cited by 3 publications

References 22 publications

Risk Factors and Heart Rate Variability Associated with Left Ventricular Enlargement in Patients with Frequent Premature Ventricular Contractions

Risk Factors and Heart Rate Variability Associated with Left Ventricular Enlargement in Patients with Frequent Premature Ventricular Contractions

The Relationship between Depression Symptoms and Physical Activity in Children with Idiopathic Ventricular Extrasystoles

High Burden Ventricular Ectopy > 10% in Children with Structurally Normal Hearts: Investigating the Association of Ventricular Ectopy Frequency, Holter and ECG Findings, and Ventricular Dysfunction

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