Ventricular structure electrical remodeling and arrhythmia in elderly patients with chronic congestive heart failure

AIM To investigate the relation between ventricular structural electrocardiological remodeling and ventricular arrhythmia in elderly patients with chronic congestive heart failure (CHF) secondary to old myocardial infarction. METHODS Fifty-five elderly patients with CHF secondary to old myocardial infarction (23 in cardiac function class II, 15 in class III, 17 in class IV, NYHA ) and in 30 age-matched elderly patients with cardiac function class I (NYHA ) secondary to old myocardial infarction were included in this study. Their ventricular chamber sizes, QT, QTc intervals and the ventricular arrhythmia were assessed respectively with echocardiography, standard 12-lead electrocardiography and 24-hour Holter recordings. RESULTS The ventricular chamber sizes were significantly larger in the elderly patients with CHF than those in cardiac function class I group [CHF group: left ventricular end diastolic diameter (LVEDD) (57±8) mm; left ventricular end systolic diameter (LVESD) (45±8) mm vs. cardiac function class I group: LVEDD (45±5) mm; LVESD ( 31±5) mm, P0.05, respectively]. However, there was no difference in ventricular repolarization indices between the two groups [CHF group: QT ( 0.41±0.07) s; QTc ( 0.44±0.06) s vs. cardiac function class I group: QT (0.41±0.04) s, QTc(0.44±0.04) s, respectively]. The ventricular arrhythmogenesis was also not found to be significantly higher in the elderly patients with CHF than those in cardiac function class I group [CHF group: ventricular premature beat (VPB) (219±598)1/24 h vs. cardiac function class I group: VPB(345±504)1/24 h]. CONCLUSION The ventricular structural remodeling enlargement is significant in elderly patients with CHF secondary to old myocardial infarction. However, the ventricular structural remodeling enlargement does not cause significant prolongation of the ventricular repolarization and the increase of the ventricular arrhythmogenesis in CHF.