title: Association between ventricular arrhythmias and myocardial mechanical dispersion assessed by strain analysis in patients with nonischemic cardiomyopathy.
abstract: BACKGROUND
  Mechanical dispersion (MD), defined as the standard deviation of time to maximum myocardial shortening assessed by 2D speckle tracking echocardiographic strain imaging (2DS), has been recently proposed as a predictor for ventricular tachycardia or fibrillation (VT/VF) in patients with ischemic cardiomyopathy and long QT syndrome. However, the role of MD in patients with non-ischemic cardiomyopathy (NICM) has not yet been studied.
  
  
  RESULTS
  In 20 patients with NICM (mean age 62 ± 11 years, 75 % male, mean EF 32 ± 6 %, mean QRS duration 102 ± 14 ms), we measured longitudinal strain by 2DS in a 16-segment left ventricular model and calculated the MD. Patients were divided into two groups, defined by the presence or absence of documented VT/VF. In 11 patients (55 %), VT/VF was documented. The median time from VT/VF to echocardiographic examination was 26 (IQR 15-58) months. There were no significant differences in baseline characteristics between patients with and without index events. MD was significantly greater in patients with VT/VF as compared to those without arrhythmias (84 ± 31 ms vs. 53 ± 16 ms, p = 0.017). The analysis of the ROC curve (AUC 0.81, 95 % CI 0.63-1.00, p = 0.017) revealed that dispersion >50 ms is associated with twelve times higher risk of VT/VF in patients with NICM (OR 12.5, 95 % CI 1.1-143.4, p = 0.024).
  
  
  CONCLUSIONS
  In this small cohort of NICM patients, greater MD was associated with a higher incidence of VT/VF.
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany. jedrzejkosiuk@hotmail.com.
authors.forename: Jedrzej
authors.initials: J
authors.lastname: Kosiuk
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Borislav
authors.initials: B
authors.lastname: Dinov
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Koutalas
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mussigbrodt
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Phillipp
authors.initials: P
authors.lastname: Sommer
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Sergio
authors.initials: S
authors.lastname: Richter
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Department of Electrophysiology, Heart Center Leipzig, Strümpellstr. 39, 04289, Leipzig, Germany.|Agaplesion Diakonie Kliniken Kassel, Herkulesstraße 34, 34119, Kassel, Germany.
authors.forename: Ole A
authors.initials: OA
authors.lastname: Breithardt
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012306:Risk; D017180:Tachycardia, Ventricular / Q000453:epidemiology / Q000503:physiopathology*; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000503:physiopathology*
keywords: Echocardiography; Mechanical dispersion; Speckle tracking; Ventricular arrhythmias