The Role of Advanced Glycation End Products in the Etiology of Premature Ventricular Contractions

OBJECTIVE
Although the pathophysiological mechanisms responsible for premature ventricular contractions (PVC) are not fully understood, they are primarily thought to occur due to increased automaticity, triggered activity, and reentry. Advanced glycation end products (AGEs) are believed to contribute to these mechanisms. This study aimed to compare AGE levels in patients with and without a PVC rate exceeding 5% in 24-hour Holter monitoring.


METHOD
Patients were divided into two groups: the PVC case group, defined as having a PVC burden with frequent premature ventricular contractions (≥ 5%) in 24-hour Holter monitoring, and the control group, defined as having rare PVC (< 5%). The patient group consisted of 65 individuals, and the control group also included 65 individuals. For the study, patients' skin AGE levels were measured using a spectrophotometric method.


RESULTS
A significant difference was observed in AGE levels between the two groups. The AGE level was 2.6 (2.1-2.9) AU in the PVC case group, while it was 2.0 (1.7-2.3) AU in the control group (P < 0.001). The receiver operating characteristics curve analysis resulted in an area under the curve value of 0.760 with a 95% confidence interval (CI) of 0.679-0.841 for detecting a PVC burden exceeding 5%. In patients with an AGE level of 2.4 AU, the sensitivity was 61.5%, and the specificity was 80% in detecting a PVC burden above 5%.


CONCLUSION
Our study showed that AGE levels may be independently and positively associated with a high PVC burden.