Prognostic relevance of ventricular arrhythmias in surgical patients with gastrointestinal tumors

Jiao-Jie Xue; Su-Tian Hu; Chong-Chong Wang; Zhi-Chong Chen; Shi-Yao Cheng; Shu-Qi Yu; Hua-Jing Peng; Yi-Tao Zhang; Wei-Jie Zeng

doi:10.4251/wjgo.v16.i5.1787

Prognostic relevance of ventricular arrhythmias in surgical patients with gastrointestinal tumors

World J Gastrointest Oncol. 2024 May 15;16(5):1787-1795. doi: 10.4251/wjgo.v16.i5.1787.

Authors

Jiao-Jie Xue¹, Su-Tian Hu¹, Chong-Chong Wang², Zhi-Chong Chen¹, Shi-Yao Cheng¹, Shu-Qi Yu³, Hua-Jing Peng⁴, Yi-Tao Zhang¹, Wei-Jie Zeng⁵

Affiliations

¹ Department of Cardiovascular Internal Medicine, Sun Yat-sen University Sixth Affiliated Hospital, Guangzhou 510655, Guangdong Province, China.
² Department of Cardiovascular Internal Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510700, Guangdong Province, China.
³ Department of Ultrasound, Fuwai Hospital, Chinese Academy of Medical Sciences Shenzhen, Shenzhen 518052, Guangdong Province, China.
⁴ Department of Kidney Internal Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou 510062, Guangdong Province, China.
⁵ Department of Cardiovascular Internal Medicine, Sun Yat-sen University Sixth Affiliated Hospital, Guangzhou 510655, Guangdong Province, China. zengweijie@mail.sysu.edu.cn.

Abstract

Background: Individuals diagnosed with gastrointestinal tumors are at an increased risk of developing cardiovascular diseases. Among which, ventricular arrhythmia is a prevalent clinical concern. This suggests that ventricular arrhythmias may have predictive value in the prognosis of patients with gastrointestinal tumors.

Aim: To explore the prognostic value of ventricular arrhythmias in patients with gastrointestinal tumors receiving surgery.

Methods: We retrospectively analyzed data from 130 patients undergoing gastrointestinal tumor resection. These patients were evaluated by a 24-h ambulatory electrocardiogram (ECG) at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2020. Additionally, 41 general healthy age-matched and sex-matched controls were included. Patients were categorized into survival and non-survival groups. The primary endpoint was all-cause mortality, and secondary endpoints included major adverse cardiovascular events (MACEs).

Results: Colorectal tumors comprised 90% of cases. Preoperative ambulatory ECG monitoring revealed that among the 130 patients with gastrointestinal tumors, 100 (76.92%) exhibited varying degrees of premature ventricular contractions (PVCs). Ten patients (7.69%) manifested non-sustained ventricular tachycardia (NSVT). The patients with gastrointestinal tumors exhibited higher PVCs compared to the healthy controls on both conventional ECG [27 (21.3) vs 1 (2.5), P = 0.012] and 24-h ambulatory ECG [14 (1.0, 405) vs 1 (0, 6.5), P < 0.001]. Non-survivors had a higher PVC count than survivors [150.50 (7.25, 1690.50) vs 9 (0, 229.25), P = 0.020]. During the follow-up period, 24 patients died and 11 patients experienced MACEs. Univariate analysis linked PVC > 35/24 h to all-cause mortality, and NSVT was associated with MACE. However, neither PVC burden nor NSVT independently predicted outcomes according to multivariate analysis.

Conclusion: Patients with gastrointestinal tumors exhibited elevated PVCs. PVCs > 35/24 h and NSVT detected by 24-h ambulatory ECG were prognostically significant but were not found to be independent predictors.

Keywords: Gastrointestinal tumor; Major adverse cardiovascular events; Prognostic; Surgery; Ventricular arrhythmia.