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Combined right and left ventricular mechanical dispersion enhance the arrhythmic risk stratification in hypertrophic

Nicoleta-Monica Popa-Fotea1, Miruna Mihaela Micheu2, Sebastian Onciul1

  • 1Department of Cardiology, Clinical Emergency Hospital of Bucharest, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.

Journal of Cardiology
|June 9, 2020
PubMed

Insights

Mechanical dispersion in hypertrophic cardiomyopathy (HCM) patients correlates with ventricular arrhythmias. Combined left and right ventricular mechanical dispersion may improve risk stratification for HCM patients with non-sustained ventricular tachycardia.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Medical Imaging

Background:

  • Ventricular arrhythmias are a primary cause of sudden cardiac death in hypertrophic cardiomyopathy (HCM).
  • Assessing mechanical dispersion (MD) in both ventricles may offer new insights into arrhythmia risk.

Purpose of the Study:

  • To investigate the correlation between combined left ventricular (LV) and right ventricular (RV) mechanical dispersion (MD) and ventricular arrhythmias in HCM.
  • To determine if MD enhances arrhythmic risk stratification in HCM patients.

Main Methods:

  • 47 HCM patients and 36 healthy controls underwent ECG monitoring and transthoracic echocardiography with strain rate imaging.
  • LV and RV mechanical dispersion (MD) calculated as standard deviation of time from R wave peak to maximum ventricular shortening.
  • Non-sustained ventricular tachycardia (NSVT) characterized by number, rate, and duration.

Main Results:

  • HCM patients with NSVT exhibited significantly increased LVMD and RVMD compared to those without NSVT and healthy controls.
  • Optimal cut-off values for LVMD and RVMD were identified as 62ms and 39ms, respectively.
  • LVMD and RVMD were independent predictors of NSVT and improved risk stratification.

Conclusions:

  • Increased LV and RV mechanical dispersion correlate with the presence of NSVT in HCM patients.
  • Combined LV and RV mechanical dispersion can enhance the risk stratification of HCM patients with NSVT.
Abstract

Keywords:
Arrhythmia risk stratificationHypertrophic cardiomyopathyLeft ventricular mechanical dispersionNon-sustained ventricular tachycardiaRight ventricular mechanical dispersion

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