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Mechanical Dispersion in Dilated and Non-Dilated Left Ventricular Cardiomyopathy: A New Frontier in Arrhythmic Risk

Nicoleta-Cosmina Hart-Foia1,2, Alexandra Dădârlat-Pop1,3, Renata Agoston2

  • 14th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.

Journal of Clinical Medicine
|April 14, 2026
PubMed

Insights

Mechanical dispersion (MD) may improve sudden cardiac death (SCD) risk prediction in cardiomyopathy patients. This echocardiography marker identifies higher arrhythmic risk, independent of traditional measures like ejection fraction.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Sudden cardiac death (SCD) remains a significant risk in dilated (DCM) and non-dilated left ventricular cardiomyopathy (NDLVC).
  • Current risk stratification using ejection fraction, scar burden, and genetics is insufficient for accurate prediction.
  • Mechanical dispersion (MD) from speckle-tracking echocardiography offers a potential marker for arrhythmic risk by assessing regional contraction timing variability.

Purpose of the Study:

  • To review the predictive value of MD for ventricular arrhythmias (VA) and SCD in DCM and NDLVC.
  • To examine the relationship between MD, myocardial fibrosis (MF), and established echocardiographic markers.

Main Methods:

  • Narrative review of prospective and retrospective studies.
  • Analysis of data from speckle-tracking echocardiography for MD calculation.
  • Comparison of MD with left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR).

Main Results:

  • Increased MD consistently predicts higher arrhythmic risk in DCM patients, often independent of LVEF and GLS.
  • Risk prediction thresholds for MD range from 50 ms to 90 ms, with significant hazard ratios.
  • The correlation between MD and myocardial fibrosis (MF) is complex; VA can occur with or without detectable fibrosis, suggesting other contributing factors.

Conclusions:

  • Mechanical dispersion (MD) shows promise for enhancing SCD risk stratification in DCM and NDLVC.
  • MD may capture arrhythmogenic substrate components missed by conventional markers.
  • Further research is needed to fully elucidate the mechanisms linking MD, fibrosis, and arrhythmias.

Keywords:
dilated cardiomyopathymechanical dispersionmyocardial fibrosisnon-dilated left ventricular cardiomyopathysudden cardiac deathventricular arrhythmias

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