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Prediction of Ventricular Arrhythmias With Left Ventricular Mechanical Dispersion: A Systematic Review and

Hiroshi Kawakami1, Nitesh Nerlekar1, Kristina H Haugaa2

  • 1Baker Heart and Diabetes Institute, Melbourne, Australia.

JACC. Cardiovascular Imaging
|June 17, 2019
PubMed

Insights

Left ventricular mechanical dispersion (LVMD) is a strong predictor of ventricular arrhythmias (VAs). Higher LVMD levels significantly increase the risk of VA events, outperforming traditional markers like ejection fraction for patient risk stratification.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Left ventricular mechanical dispersion (LVMD) assessed by speckle tracking shows promise for ventricular arrhythmia (VA) risk stratification.
  • Existing studies are primarily single-center, necessitating a comprehensive analysis.

Purpose of the Study:

  • To systematically review and meta-analyze the association between LVMD and the incidence of VA.
  • To compare the prognostic value of LVMD against other cardiac parameters.

Main Methods:

  • Systematic review and meta-analysis of studies reporting LVMD's predictive value for VA.
  • VA events defined as sudden cardiac death, cardiac arrest, ventricular tachyarrhythmia, or appropriate ICD therapy.
  • Extracted hazard ratios from univariate and multivariate models; compared LVMD with LVEF and GLS.

Main Results:

  • Included 3,198 patients from 12 studies; 12% experienced VA events.
  • Patients with VA had significantly greater LVMD (weighted mean difference -20.3 ms).
  • Each 10 ms increase in LVMD independently associated with higher VA risk (HR 1.19).

Conclusions:

  • LVMD assessed by speckle tracking is a valuable predictor of VA across various cardiac conditions.
  • LVMD demonstrates superior predictive value compared to LVEF and GLS for VA risk stratification.
Abstract

Keywords:
mechanical dispersionmeta-analysisstrainventricular arrhythmia

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