{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:48:03Z","timestamp":1792118883611,"version":"4.4.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2023,12,12]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The consequences of exercise-induced premature ventricular contractions (PVCs) in asymptomatic individuals remain unclear. This study aimed to assess the association between PVC burdens during submaximal exercise and major adverse cardiovascular events (MI\/HF\/LTVA: myocardial infarction [MI], heart failure [HF], and life-threatening ventricular arrhythmia [LTVA]), and all-cause mortality. Additional end points were MI, LTVA, HF, and cardiovascular mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>A neural network was developed to count PVCs from ECGs recorded during exercise (6 minutes) and recovery (1 minute) in 48\u2009315 asymptomatic participants from UK Biobank. Associations were estimated using multivariable Cox proportional hazard models. Explorative studies were conducted in subgroups with cardiovascular magnetic resonance imaging data (n=6290) and NT-proBNP (N-terminal Pro-B-type natriuretic peptide) levels (n=4607) to examine whether PVC burden was associated with subclinical cardiomyopathy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Mean age was 56.8\u00b18.2 years; 51.1% of the participants were female; and median follow-up was 12.6 years. Low PVC counts during exercise and recovery were both associated with MI\/HF\/LTVA risk, independently of clinical factors: adjusted hazard ratio (HR), 1.2 (1\u20135 exercise PVCs,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and HR, 1.3 (1\u20135 recovery PVCs,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Risks were higher with increasing PVC count: HR, 1.8 (&gt;20 exercise PVCs,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and HR, 1.6 (&gt;5 recovery PVCs,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). A similar trend was observed for all-cause mortality, although associations were only significant for high PVC burdens: HRs, 1.6 (&gt;20 exercise PVCs,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and 1.5 (&gt;5 recovery PVCs,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Complex PVC rhythms were associated with higher risk compared with PVC count alone. PVCs were also associated with incident HF, LTVA, and cardiovascular mortality, but not MI. In the explorative studies, high PVC burden was associated with larger left ventricular volumes, lower ejection fraction, and higher levels of NT-proBNP compared with participants without PVCs.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>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. Complex PVC rhythms were associated with higher risk compared with PVC count alone. Underlying mechanisms may include the presence of subclinical cardiomyopathy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.064633","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T09:01:04Z","timestamp":1697706064000},"page":"1932-1944","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Prognostic Significance of Different Ventricular Ectopic Burdens During Submaximal Exercise in Asymptomatic UK Biobank Subjects"],"prefix":"10.1161","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8897-558X","authenticated-orcid":true,"given":"Stefan","family":"van Duijvenboden","sequence":"first","affiliation":[{"name":"Institute of Cardiovascular Science, University College London, United Kingdom (S.v.D., M.O., P.D.L.)."},{"name":"William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (S.v.D., J.R., N.A., S.E.P., A.T., P.B.M.)."},{"name":"Nuffield Department of Population Health, University of Oxford, United Kingdom (S.v.D., A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-5866","authenticated-orcid":true,"given":"Julia","family":"Ram\u00edrez","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (S.v.D., J.R., N.A., S.E.P., A.T., P.B.M.)."},{"name":"Aragon Institute of Engineering Research, University of Zaragoza, Spain and Centro de Investigaci\u00f3n Biom\u00e9dica en Red \u2013 Bioingenier\u00eda, Biomateriales y Nanomedicina, Spain (J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5773-0344","authenticated-orcid":true,"given":"Michele","family":"Orini","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London, United Kingdom (S.v.D., M.O., P.D.L.)."},{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, London, United Kingdom (M.O., N.A., S.E.P. 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