Arrhythmias & electrophysiologyCohort study
Prognostic Significance of Different Ventricular Ectopic Burdens During Submaximal Exercise in Asymptomatic UK Biobank Subjects
- Prospective cohort study
- UK Biobank
- neural network PVC count
- multivariable Cox models
Authors' conclusion
In this cohort of middle-aged and older adults, PVC count during submaximal exercise and recovery were both associated with MI/HF/LTVA, all-cause mortality, HF, LTVAs, and cardiovascular mortality, independent of clinical and exercise test factors, indicating an incremental increase in risk as PVC count rises.
Study context
- Population
- Asymptomatic UK Biobank participants with ECG during exercise (6 min) and recovery (1 min); mean age 56.8±8.2 years, 51.1% female
- Participants
- 48,315 participants
- Exposure
- PVC burden during submaximal exercise and recovery vs no premature ventricular contractions (PVCs)
- Outcome
- MI/HF/LTVA (MI, HF, life-threatening ventricular arrhythmia) and all-cause mortality
- Follow-up
- Median 12.6 years
Main finding
As reported in the abstract
MI/HF/LTVA
- 1-5 exercise PVCs
- adjusted HR 1.2; P < 0.001
- 1-5 recovery PVCs
- adjusted HR 1.3; P < 0.001
- >20 exercise PVCs
- HR 1.8; P < 0.001
- >5 recovery PVCs
- HR 1.6; P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| All-cause mortality — >20 exercise PVCs vs No PVCs | 1.6 | P < 0.001 |
| All-cause mortality — >5 recovery PVCs vs No PVCs | 1.5 | P < 0.001 |
All-cause mortality
- Similar trend; associations significant only for high PVC burdens
Complex PVC rhythms
- Associated with higher risk than PVC count alone
Incident HF, LTVA, CV mortality, MI
- PVCs associated with HF, LTVA and CV mortality, but not MI
Subclinical cardiomyopathy (CMR n=6290; NT-proBNP n=4607, explorative)
- High PVC burden associated with larger LV volumes, lower EF and higher NT-proBNP vs no PVCs
- explorative
Original publication
Prognostic Significance of Different Ventricular Ectopic Burdens During Submaximal Exercise in Asymptomatic UK Biobank Subjects. Circulation. Published 19 October 2023. doi:10.1161/circulationaha.123.064633
Summarised from the published abstract; every number is checked against it