Predictors of adverse outcome in patients with frequent premature ventricular complexes: The ABC-VT risk score.
Cardiomyopathy
Left ventricular remodeling
Premature ventricular complexes
Risk score
Ventricular tachycardia
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
18
01
2020
accepted:
14
02
2020
pubmed:
29
2
2020
medline:
1
9
2021
entrez:
29
2
2020
Statut:
ppublish
Résumé
No independently validated score currently exists for risk stratification of patients with frequent premature ventricular complexes (PVCs). The purpose of this study was to develop a risk score to predict adverse events in patients with frequent PVCs. We analyzed consecutive patients between 2012 and 2017 undergoing 14-day continuous monitoring with frequent PVCs (>5%) and concurrent echocardiography. We performed binary logistic regression to determine multivariate predictors of adverse left ventricular remodeling (left ventricular ejection fraction [LVEF] <45% or left ventricular end-diastolic volume index >75 mL/m The derivation cohort comprised 206 patients with a mean PVC burden of 11.6% ± 6.2% and considerable daily fluctuation (minimum burden 7.3% ± 6.2% vs maximum 17.9% ± 8.0%). Independent predictors of adverse remodeling were as follows: superiorly directed PVC axis (OR 2.7; 1 point), PVC burden 10%-20% (OR 3.5; 2 points) and >20% (OR 4.4; 3 points), PVC coupling interval >500 ms (OR 4.7; 4 points), nonsustained ventricular tachycardia (OR 5.3; 4 points), which form the ABC-VT risk score. This score predicted future adverse events in both validation cohorts: cohort 1, hazard ratio 1.43; 95% confidence interval 1.19-1.73; P < .001 and cohort 2, hazard ratio 1.22; 95% confidence interval 1.05-1.42; P = .01. The ABC-VT score is a simple tool that predicts adverse left ventricular remodeling and future clinical deterioration in patients with frequent PVCs.
Sections du résumé
BACKGROUND
No independently validated score currently exists for risk stratification of patients with frequent premature ventricular complexes (PVCs).
OBJECTIVES
The purpose of this study was to develop a risk score to predict adverse events in patients with frequent PVCs.
METHODS
We analyzed consecutive patients between 2012 and 2017 undergoing 14-day continuous monitoring with frequent PVCs (>5%) and concurrent echocardiography. We performed binary logistic regression to determine multivariate predictors of adverse left ventricular remodeling (left ventricular ejection fraction [LVEF] <45% or left ventricular end-diastolic volume index >75 mL/m
RESULTS
The derivation cohort comprised 206 patients with a mean PVC burden of 11.6% ± 6.2% and considerable daily fluctuation (minimum burden 7.3% ± 6.2% vs maximum 17.9% ± 8.0%). Independent predictors of adverse remodeling were as follows: superiorly directed PVC axis (OR 2.7; 1 point), PVC burden 10%-20% (OR 3.5; 2 points) and >20% (OR 4.4; 3 points), PVC coupling interval >500 ms (OR 4.7; 4 points), nonsustained ventricular tachycardia (OR 5.3; 4 points), which form the ABC-VT risk score. This score predicted future adverse events in both validation cohorts: cohort 1, hazard ratio 1.43; 95% confidence interval 1.19-1.73; P < .001 and cohort 2, hazard ratio 1.22; 95% confidence interval 1.05-1.42; P = .01.
CONCLUSION
The ABC-VT score is a simple tool that predicts adverse left ventricular remodeling and future clinical deterioration in patients with frequent PVCs.
Identifiants
pubmed: 32109563
pii: S1547-5271(20)30170-3
doi: 10.1016/j.hrthm.2020.02.020
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1066-1074Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.