Higher ventricular premature complex burden is associated with lower systolic blood pressure response

Background: Ventricular premature complexes (VPCs) with a burden higher than 10% to 20% of total daily heart beats can cause VPC-induced cardiomyopathy. The systolic blood pressure response (SBPR) is the difference between the SBP during maximal exercise and rest. A low SBPR was recently identified to be a marker of cardiomyopathy. The aim of this manuscript was to clarify the association between VPC burden and SBPR. Methods: From January to December 2015, all patients with a VPC burden larger than 240 beats/day on Holter recordings and treadmill exercise tests were enrolled. The patients with a heart rhythm other than sinus rhythm, coronary artery disease, and severe cardiomyopathy were excluded. The SBPR was measured during a treadmill test. The basic characteristics and echocardiographic findings were collected. Results: All patients were classified into three groups: Group 1; 240-1,000 VPCs/day (n = 78), Group 2; 1,000-10,000 VPCs/day (n = 54), and Group 3; > 10,000 VPCs/day (n = 21). Group 1 had a higher SBPR than the other groups. Multivariate analysis revealed that only VPC burden was associated with SBPR. Receiver operating characteristic curve analysis showed that a VPC burden > 1,055 beats/day predicted a SBPR < 40 mmHg. The results were consistent in all subgroups. There were no significant differences in echocardiographic findings among the groups. Conclusions: AVPC burden higher than 1,055 beats/day was associated with a reduced SBPR.