ArticleJournal of the American College of Cardiology2020
Persistent Proarrhythmic Neural Remodeling Despite Recovery From Premature Ventricular Contraction-Induced Cardiomyopathy.
Article in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 41 citations in OpenAlex.
- Effect of olfactory stimulation from aromatherapy on the autonomic nervous activity during aerobic exercises.Scientific reports · 2024Trial
- Outcomes of Premature Ventricular Contraction-Cardiomyopathy in the Veteran Population: A Secondary Analysis of the CHF-STAT Study.JACC. Clinical electrophysiology · 2021Trial
- High Burden of Premature Ventricular Contractions Upregulates Transcriptional Markers of Inflammation and Promotes Adverse Cardiac Remodeling Linked to Cardiomyopathy.Circulation. Arrhythmia and electrophysiology · 2026Article
- Development of an electrocardiographic prediction model for outflow tract idiopathic premature ventricular contraction with decreased left ventricular ejection fraction.European journal of medical research · 2025Article
- The Role of Infarct Border Zone Remodelling in Ventricular Arrhythmias: Bridging Basic Research and Clinical Applications.Journal of cellular and molecular medicine · 2025Review
- Clinical neurocardiology: defining the value of neuroscience-based cardiovascular therapeutics - 2024 update.The Journal of physiology · 2025Review
- Mechanisms and Risk Factors for Premature Ventricular Contraction Induced Cardiomyopathy.Reviews in cardiovascular medicine · 2023Review
- Alterations of sarcoplasmic reticulum-mediated CaMolecular and cellular biochemistry · 2023Article
- Relationship between epicardial adipose tissue measured by computed tomography and premature ventricular complexes originating from different sites.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Ticagrelor Can Regulate the Ion Channel Characteristics of Superior Cervical Ganglion Neurons after Myocardial Infarction.Journal of cardiovascular development and disease · 2023Article
- Stellate Ganglia and Cardiac Sympathetic Overactivation in Heart Failure.International journal of molecular sciences · 2022Review
- A Heart Premonition: When the Heart Senses Something Premature Is About to Happen!JACC. Clinical electrophysiology · 2022Article
- Empiric ablation of asymptomatic PVCs when there is greater than 20% burden but normal left ventricular function-An argument in support of catheter ablation.Heart rhythm O2 · 2021Article
- Eccentric hypertrophy in an animal model of mid- and long-term premature ventricular contraction-induced cardiomyopathy.Heart rhythm O2 · 2021Article
- The Burden of Ventricular Premature Complex Is Associated With Cardiovascular Mortality.Frontiers in cardiovascular medicine · 2021Article
- Is PVC-Induced Cardiomyopathy Truly Reversible?: A Deep Dive Into Questions That Remain Unanswered.JACC. Clinical electrophysiology · 2020Article
- Clinical and translational insights on premature ventricular contractions and PVC-induced cardiomyopathy.Progress in cardiovascular diseasesReview
- Premature Ventricular Complexes: Benign versus Malignant - How to approach?Indian pacing and electrophysiology journalArticle
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe presence and significance of neural remodeling in premature ventricular contraction-induced cardiomyopathy (PVC-CM) remain unknown.
objectivesThis study aimed to characterize cardiac sympathovagal balance and proarrhythmia in a canine model of PVC-CM.
methodsIn 12 canines, the investigators implanted epicardial pacemakers and radiotelemetry units to record cardiac rhythm and nerve activity (NA) from the left stellate ganglion (SNA), left cardiac vagus (VNA), and arterial blood pressure. Bigeminal PVCs (200 ms coupling) were applied for 12 weeks to induce PVC-CM in 7 animals then disabled for 4 weeks to allow complete recovery of left ventricular ejection fraction (LVEF), versus 5 sham controls.
resultsAfter 12 weeks of PVCs, LVEF (p = 0.006) and dP/dT (p = 0.007) decreased. Resting SNA (p = 0.002) and VNA (p = 0.04), exercise SNA (p = 0.01), SNA response to evoked PVCs (p = 0.005), heart rate (HR) at rest (p = 0.003), and exercise (p < 0.04) increased, whereas HR variability (HRV) decreased (p = 0.009). There was increased spontaneous atrial (p = 0.02) and ventricular arrhythmias (p = 0.03) in PVC-CM. Increased SNA preceded both atrial (p = 0.0003) and ventricular (p = 0.009) arrhythmia onset. Clonidine suppressed SNA and abolished all arrhythmias. After disabling PVC for 4 weeks, LVEF (p = 0.01), dP/dT (p = 0.047), and resting VNA (p = 0.03) recovered to baseline levels. However, SNA, resting HR, HRV, and atrial (p = 0.03) and ventricular (p = 0.03) proarrhythmia persisted. There was sympathetic hyperinnervation in stellate ganglia (p = 0.02) but not ventricles (p = 0.2) of PVC-CM and recovered animals versus sham controls.
conclusionsNeural remodeling in PVC-CM is characterized by extracardiac sympathetic hyperinnervation and sympathetic neural hyperactivity that persists despite normalization of LVEF. The altered cardiac sympathovagal balance is an important trigger and substrate for atrial and ventricular proarrhythmia.
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