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) formation are not fully known, it is thought to occur mainly due to increased automaticity, triggered activity and reentry. Advanced glycation end products (AGEs) are thought to trigger these mechanisms. We aimed to compare the AGE levels of patients with and without PVC rate over 5% in 24-hour rhythm Holter monitoring.

METHODS
Patients were divided into two groups: PVC case group is defined as PVC burden that had frequent premature ventricular contraction ≥5% in 24-h Holter monitoring, and control group is defined as rare PVC <5%. The patient group consisted of 65 patients, and the control group consisted of 65 patients. For the study, patients' skin AGEs levels were measured using spectrophotometric method.

RESULTS
Significant difference was observed in terms of AGE levels between the two groups. While the AGE level was 2.6 (2.1-2.9) AU in the PVC case group, the AGE level 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 curve value of 0.760 with a 95% confidence interval (CI) of 0.679-0.841 for the ability to detect 5% above PVC burden. In patients with AGE level 2.4 AU, it had a sensitivity of 61.5% and a specificity of 80% in detecting PVC burden above 5%

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