Rapid Fire Abstracts
Salman Pervaiz, MD
Clinical Research Assistant
The Ohio State University
Salman Pervaiz, MD
Clinical Research Assistant
The Ohio State University
Yu Kang, MD
Clinical Inst HS
The Ohio State University
James Whayne, MSc
Chief Clinical Officer
Myocardial Solutions, Inc.
Yuwei Wang, MD
Attending Radiologist
Taichung Veterans General Hospital, Taiwan (Republic of China)
Chong Chen, PhD
Research Scientist
The Ohio State University
Alyssa Marie Castillo, MSc
Research assistant
The Ohio State University Wexner Medical Center
Katherine Binzel, PhD
Research Scientist
The Ohio State University
Rizwan Ahmad, PhD
Associate Professor
The Ohio State University
Muhammad R. Afzal, MD
Assistant Professor
The Ohio State University
Orlando P. Simonetti, PhD
Professor
The Ohio State University
Yuchi Han, MD
Professor
The Ohio State University
Patients with frequent premature ventricular contractions (PVCs) are at risk of developing PVC-induced cardiomyopathy. It has been demonstrated previously that sinus beats in patients with frequent PVCs exhibit significant dyssynchrony [1]. In this study, we sought to evaluate this relation using strain-encoded (SENC) imaging, which is a highly reproducible method for detecting subclinical cardiac abnormalities.
Methods:
Patients with a PVC burden of at least 9.5% were prospectively enrolled from the Ohio State University Wexner Medical Center. A cohort of healthy volunteers served as the control population. Cardiac MRI was performed on a 1.5 T scanner (Sola, Siemens) with SENC imaging. We measured global longitudinal and global circumferential strains (GLS, GCS) as well as standard deviation of time-to-peak strain (SDTTPS) of each segment. Only sinus beats were included in SENC analysis. PVC ejection fraction (EF) was analyzed on a beat-to-beat basis using sinus beats only. A Mann-Whitney U test was performed to analyze the difference between groups.
Results: A total of 37 patients with PVCs (mean age: 55.3±16.3 years, males: 18/48.7%) and 19 healthy volunteers (mean age: 38.7±12.7 years, males:10/52.6%) were included. Among the PVC cohort, there were 10 patients with preserved left ventricular (LV) EF (EF≥55%), and 27 patients with impaired EF (EF< 55%). Impaired LVEF patients had greater LV end-systolic volume and end-systolic volume index compared to preserved LVEF patients (p=0.029, p=0.008 respectively). In patients with preserved sinus EF, there was significant dyssynchrony during sinus beats which was evidenced by a higher SDTTPS in both longitudinal and circumferential strains (Figure 1, Table 1). When comparing PVC patients with and without impaired LVEF, those with impaired systolic function exhibited greater dyssynchrony in the circumferential strain (epicardial SDTTPS CS = 96.5±42.4 ms vs 78.4±38.8 ms, p=0.026).
Conclusion:
Sinus beats in patients with frequent PVCs exhibited significant mechanical abnormalities, characterized by increased longitudinal and circumferential dyssynchrony, compared to healthy volunteers, despite preserved EF.
