Open AccessHigh incidence of ventricular arrhythmias in patients with left ventricular enlargement and moderate left ventricular dysfunction
Author(s) -
Zhao Shuang,
Chen Keping,
Su Yangang,
Hua Wei,
Yang Jiefu,
Chen Silin,
Liang Zhaoguang,
Xu Wei,
Zhang Shu
Publication year - 2016
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22588
Subject(s) - medicine , ejection fraction , cardiology , hazard ratio , implantable cardioverter defibrillator , heart failure , left ventricular hypertrophy , cardiac resynchronization therapy , sudden cardiac death , confidence interval , blood pressure
Background Left ventricular ejection fraction ( LVEF ) ≤35% is the cutoff value used to identify patients at high risk of sudden cardiac death. However, whether patients who have moderate left ventricular dysfunction and left ventricular enlargement ( LVE ) have a high risk of ventricular arrhythmias ( VAs ) and cardiac death is unclear. Hypothesis Patients with moderate left ventricular dysfunction and LVE may have a high risk of VAs . Methods This study retrospectively analyzed the data of 853 patients who have an implantable cardioverter‐defibrillator/cardiac resynchronization therapy cardioverter‐defibrillator equipped with home monitoring. The patients were divided into 4 groups: group A, 35% < LVEF ≤ 45% and left ventricular end‐diastolic dimension ( LVEDD ) ≥60 mm; group B, LVEF ≤35% and LVEDD <60 mm; group C, 35% < LVEF ≤ 45% and LVEDD <60 mm; and group D, LVEF ≤35% and LVEDD ≥60 mm. Results During a mean follow‐up period of 30 ± 13 months, 324 patients (38%) experienced VAs and 125 patients (14.7%) experienced cardiac death. Based on multivariate Cox regression modeling, group A had an increased risk of VAs (A vs B, hazard ratio [ HR ]: 1.563, 95% confidence interval [ CI ]: 1.029‐2.375, P = 0.036; A vs C, HR : 1.661, 95% CI : 1.204‐2.294, P = 0.002) and cardiac death (A vs B, HR : 1.845, 95% CI : 1.013‐3.356; A vs C, HR : 2.041, 95% CI : 1.136‐3.731, P = 0.021). Conclusions Patients with moderate left ventricular dysfunction and LVE have a high risk of VAs and cardiac death.