Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. May 15, 2024; 16(5): 1787-1795
Published online May 15, 2024. doi: 10.4251/wjgo.v16.i5.1787
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
Jiao-Jie Xue, Su-Tian Hu, Zhi-Chong Chen, Shi-Yao Cheng, Yi-Tao Zhang, Wei-Jie Zeng, Department of Cardiovascular Internal Medicine, Sun Yat-sen University Sixth Affiliated Hospital, Guangzhou 510655, Guangdong Province, China
Chong-Chong Wang, Department of Cardiovascular Internal Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510700, Guangdong Province, China
Shu-Qi Yu, Department of Ultrasound, Fuwai Hospital, Chinese Academy of Medical Sciences Shenzhen, Shenzhen 518052, Guangdong Province, China
Hua-Jing Peng, Department of Kidney Internal Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou 510062, Guangdong Province, China
Co-first authors: Jiao-Jie Xue and Su-Tian Hu.
Co-corresponding authors: Yi-Tao Zhang and Wei-Jie Zeng.
Author contributions: Xue JJ made contributions to study design, data collection and data analyses. Hu ST contributed to the draft of the manuscript. They are the co-first authors of this article. Zeng WJ made contributions to study design, data collection and data analyses. Zhang YT helped critically revise the manuscript for intellectual content. They are the co-corresponding authors of this article. Xue JJ and Zeng WJ made contributions to study design, data collection, and data analyses; Hu ST and Wang CC contributed to the draft of the manuscript; Chen ZC, Cheng SY, Yu SQ, and Peng HJ were responsible for data collection and creation of the tables and figures presented in the manuscript; Zhang YT and Zeng WJ helped critically revise the manuscript for intellectual content; and all authors read and approved the final manuscript.
Supported by the Sixth Affiliated Hospital of Sun Yat-sen University Clinical Research-1010 Program, No. 1010PY (2023)-06; the National Nature Science Foundation of China, No. 81400301; the Fundamental Research Funds for the Central Universities, No. 19ykpy10; and Guangzhou Health Science and Technology Project, No. 20231A010068.
Institutional review board statement: The study has been approved by the local ethics committee of the Sixth Affiliated Hospital of Sun Yat-sen University (Approval No. E2021140).
Informed consent statement: This is a retrospective cohort study. Patients were not required to give informed consent for the study, as the analysis used anonymized clinical data obtained after each patient had consented to treatment by means of written consent. Waiver informed consent had been obtained prior to conducting the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original anonymous dataset is available upon reasonable request from the corresponding author at zengweijie@mail.sysu.edu.cn.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Jie Zeng, PhD, Associate Professor, Department of Cardiovascular Internal Medicine, Sun Yat-sen University Sixth Affiliated Hospital, Erheng Road, Yuancun, Tianhe District, Guangzhou 510655, Guangdong Province, China. zengweijie@mail.sysu.edu.cn
Received: January 14, 2024
Peer-review started: January 14, 2024
First decision: January 30, 2024
Revised: February 19, 2024
Accepted: March 26, 2024
Article in press: March 26, 2024
Published online: May 15, 2024
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: Ventricular arrhythmia, Gastrointestinal tumor, Major adverse cardiovascular events, Prognostic, Surgery

Core Tip: We retrospectively analyzed data from 130 patients undergoing gastrointestinal tumor resection who were evaluated by a 24-h ambulatory electrocardiogram to determine the prognostic value of ventricular arrhythmias in these types of patients. Additionally, 41 age-matched and sex-matched general healthy controls were evaluated. In a long-term follow-up, we found that patients with gastrointestinal tumors exhibited elevated premature ventricular contractions. Premature ventricular contractions > 35/24 h and non-sustained ventricular tachycardia were prognostically significant but were not found to be independent predictors.