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Cardiologia Croatica, Vol. 16 No. 5-6, 2021.

Sažetak sa skupa

https://doi.org/10.15836/ccar2021.205

Mechanical dispersion: are we one step closer to a more reliable risk prediction of sudden cardiac death

Ante Matana orcid id orcid.org/0000-0003-3630-0374
Teodora Zaninović Jurjević orcid id orcid.org/0000-0001-9415-9618

Puni tekst: engleski pdf 145 Kb

str. 205-205

preuzimanja: 187

citiraj

Preuzmi JATS datoteku

Sažetak

Ključne riječi

mechanical dispersion; prognosis; strain echocardiography

Hrčak ID:

257090

URI

https://hrcak.srce.hr/257090

Datum izdavanja:

4.5.2021.

Posjeta: 489 *

Copyright: 2021, Croatian Cardiac Society

Date received: 28 March 2021

Date accepted: 02 April 2021

Publication date (print and electronic): April 2021

Volume: 16

Issue: 5-6

Page: 205

Publisher ID: CC 2021 16_5-6_205

DOI: 10.15836/ccar2021.205

Article Information (continued)

Categories:

Subject: Extended Abstract

KEYWORDS: :

KEYWORDS:

Keyword: mechanical dispersion

Keyword: prognosis

Keyword: strain echocardiography

Mechanical dispersion: are we one step closer to a more reliable risk prediction of sudden cardiac death

[https://orcid.org/0000-0003-3630-0374] Ante Matana

[https://orcid.org/0000-0001-9415-9618] Teodora Zaninović Jurjević[*]

 

University of Rijeka, Faculty of Medicine, University Hospital Centre Rijeka, Rijeka, Croatia

Author notes:

Correspondence to: [*] ADDRESS FOR CORRESPONDENCE: Teodora Zaninović Jurjević, Klinički bolnički centar Rijeka, Tome Strižića 3, HR-51000 Rijeka, Croatia. / Phone: + 385-98-320-768 / E-mail: teodorazj@gmail.com

Cardiovascular diseases continue to be the leading cause of death in the world. A quarter of them occur by the mechanism of sudden cardiac death. Current criteria for identifying high-risk patients are unreliable and misclassify most at-risk patients as a low-risk group. Several studies in the last ten years confirmed the usefulness of mechanical dispersion in differentiating patients with high versus low risk for sudden cardiac death. Mechanical dispersion is a consequence of slow and inhomogeneous conduction of electrical impulse in the scar border zone, resulting in inhomogeneous myocardial activation and heterogeneity of myocardial contraction. This is why mechanical dispersion is in fact an expression of electrical dispersion, but unlike electrical dispersion it can be measured more easily and more reliably. It is obtained by speckle tracking echocardiography and is expressed as the standard deviation of all time intervals to the maximum myocardial shortening. Several studies have shown this method is significantly more reliable than the left ventricular ejection fraction and the left ventricular global longitudinal strain in differentiating high-risk from low-risk patients. Best results have been obtained in conditions characterized by fibrosis and/or scarring of the myocardium, such as in patients with myocardial infarction, hypertrophic, dilated and arrhythmogenic cardiomyopathy, some valvular heart diseases and heart failure. Mechanical dispersion could be useful as a risk stratification tool in identifying patients that can optimally benefit from the prophylactic treatment. (1-3) Although promising, for now this method is not listed in the current guidelines for the prevention of sudden cardiac death. It remains to be seen whether the new ones will bring changes in this field.

LITERATURE

1 

Haugaa KH, Grenne BL, Eek CH, Ersbøll M, Valeur N, Svendsen JH, et al. Strain echocardiography improves risk prediction of ventricular arrhythmias after myocardial infarction. JACC Cardiovasc Imaging. 2013 August;6(8):841–50. https://doi.org/10.1016/j.jcmg.2013.03.005 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/23850251

2 

Candan O, Gecmen C, Bayam E, Guner A, Celik M, Doğan C. Mechanical dispersion and global longitudinal strain by speckle tracking echocardiography: Predictors of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy. Echocardiography. 2017 June;34(6):835–42. https://doi.org/10.1111/echo.13547 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/28444773

3 

Prihadi EA, Vollema EM, Ng ACT, Ajmone Marsan N, Bax JJ, Delgado V. Determinants and prognostic implications of left ventricular mechanical dispersion in aortic stenosis. Eur Heart J Cardiovasc Imaging. 2019 July 1;20(7):740–8. https://doi.org/10.1093/ehjci/jez004 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/30726895

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