P389Left atrial dilatation and shape remodeling in frequent premature ventricular contraction: a possible explanation for stroke risk

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Recent studies demonstrated that frequent premature ventricular contractions (PVCs) even if considered benign are associated with risk of incident stroke in participants free of hypertension and diabetes. PVCs may contribute to atrioventricular remodeling but their prognostic significance remains uncertain. Aim: to assess relation between PVCs burden and left atrium (LA) shape/size remodeling.Methods: the study included 162 pts aged 50.2±16.3 years (83 males) with PVCs and normal LV ejection fraction and volumes. LA dimension (LAd), LA volume (LAV) was measured. Patients with moderate and severe arterial hypertension were not included. A new measurement was introduced, basal dimension of the LA (LAb) as maximal transverse distance at base (roof) of LA. Trapezoidal LA shape was considered if transverse dimension < basal dimension.Results: Pts were divided into 2 groups based on the number of PVCs: 105 pts gr1 with < 10000/24h, 56 pts gr2 > 10000/24h). LAV ranged 35.5-128 ml; mean LAV was significant different gr1: 49.1±9.1ml, gr2: 74.5±13.1ml (p>0.0001). The mean age did not differ significantly (gr 1 48.1±18.2 and gr 2 52.2±14.2, p=0.15) Trapezoidal LA was found 85% pts gr2 and 31% gr1. The simple regression analysis demonstrated a statistically significant linear correlation between LAV and PVCs burden (r2=0.67, p<0.0001), but no statistically significant correlation between LAd and PVCs burden.Conclusions: LV filling may be impaired in patients (pts) with frequent PVC due to overlapping of LV and left atrial (LA) systole. LAV is increasead in pts with high PVCs burden suggesting increased LV filling pressure, LA stretch / dilatation and this finding may be a risk marker for incident stroke, particularly embolic stroke.

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