Systolic, diastolic, and pulse blood pressure during premature ventricular contractions: relationship with characteristics of ectopic beats

Abstract

The aim is to assess the relationship between systolic, diastolic, and pulse blood pressure (SBP, DBP, PBP) during ventricular extrasystoles (VE) and the individual characteristics of ectopic beats.Methods. The primary method of investigation was BP measurement for each heartbeat. Inclusion criteria were the presence of ≥10000 monomorphic VE per day. A total of 53 patients were included, either without structural heart changes or with minimal structural alterations. The mean of systolic, diastolic, and pulse BP (SBP, DBP, and PBP) during VE (SBP VE, DBP VE, PBP VE) and during post-extrasystolic sinus contraction (post VE SBP, post VE DBP, post VE PBP) were calculated for each patient as fractions of 1.0.Results. The QRS complex width in VE originating from the right ventricular outflow tract is greater than from the left ventricular outflow tract; fragmentation of the QRS complex is more commonly observed in these VE. Significant correlations were observed between SBP VE and mean coupling interval (CI), PBP VE and CI, and SBP VE and PBP VE, though not between DBP VE and CI. DBP VE was significantly associated with VE count and daily VE percentage, while PBP VE was associated with left ventricular ejection fraction. It has been shown that post-VE SBP and post VE DBP are lower, while post VE PBP is higher compared to the corresponding parameters of sinus beats preceding the VE. Significant relationships were found between post VE SBP and post VE PBP, the duration of the post-extrasystolic pause, and the presence of paired VE; between post VE DBP and post VE PBP, DBP VE, CI VE, the presence of non-sustained ventricular tachycardia, and daily VE percentage; between post VE PBP and DBP VE, the presence of non-sustained ventricular tachycardia, daily VE percentage, and post-extrasystolic pause duration. Post VE PBP was equally determined by values of post VE SBP and DBP.Conclusion. With the shortening of the VE coupling interval, its SBP decreases, while DBP increases slightly, which may determine its hemodynamic significance. In post-extrasystolic sinus beats, both SBP and DBP decrease.