title: Left ventricular mechanical dispersion is associated with nonsustained ventricular tachycardia in hypertrophic cardiomyopathy.
abstract: We assessed the value of speckle tracking two-dimensional (2D) strain echocardiography (2DSE) measured mechanical dispersion (MD) with other imaging and electrocardiographic parameters in differentiating hypertrophic cardiomyopathy (HCM) patients with and without nonsustained ventricular tachycardia (NSVT) on 24-h ambulatory ECG monitoring.
  
  
  
  We studied 31 patients with HCM caused by the Finnish founder mutation MYBPC3-Q1061X and 20 control subjects with comprehensive 2DSE echocardiography and cardiac magnetic resonance imaging (CMRI). The presence of NSVT was assessed from ambulatory 24-h ECG monitoring. NSVT episodes were recorded in 11 (35%) patients with HCM. MD was significantly higher in HCM patients with NSVT (93 ± 41 ms) compared to HCM patients without NSVT (50 ± 18 ms, p = 0.012) and control subjects (41 ± 16 ms, p < 0.001). MD was the only variable independently associated with the presence of NSVT (OR: 1.60, 95% CI: 1.05-2.45, p = 0.030). Assessed by ROC curves, MD performed best in differentiating between HCM patients with and without NSVT (AUC = 0.81).
  
  
  
  Increased mechanical dispersion was associated with NSVT in HCM patients on 24-h ambulatory ECG monitoring. Key messages The prediction of sudden cardiac death in hypertrophic cardiomyopathy remains a challenge and novel imaging methods are required to identify individuals at risk of malignant ventricular arrhythmias. Mechanical dispersion by speckle tracking echocardiography is associated with NSVT on 24-h ambulatory ECG monitoring in patients with hypertrophic cardiomyopathy.
authors.affiliation: a Department of Cardiology , Helsinki University Hospital, Heart and Lung Center , Helsinki , Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Jalanko
authors.affiliation: b Department of Clinical Radiology , Kuopio University Hospital , Kuopio , Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Tarkiainen
authors.affiliation: b Department of Clinical Radiology , Kuopio University Hospital , Kuopio , Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Sipola
authors.affiliation: c Heart Center, Kuopio University Hospital , Kuopio , Finland.
authors.forename: Pertti
authors.initials: P
authors.lastname: Jääskeläinen
authors.affiliation: d HUS Medical Imaging Center, Radiology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Lauerma
authors.affiliation: a Department of Cardiology , Helsinki University Hospital, Heart and Lung Center , Helsinki , Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Laine
authors.affiliation: a Department of Cardiology , Helsinki University Hospital, Heart and Lung Center , Helsinki , Finland.
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
authors.affiliation: e Institute of Clinical Medicine, Internal Medicine and Kuopio University Hospital , Kuopio , Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Laakso
authors.affiliation: a Department of Cardiology , Helsinki University Hospital, Heart and Lung Center , Helsinki , Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Heliö
authors.affiliation: e Institute of Clinical Medicine, Internal Medicine and Kuopio University Hospital , Kuopio , Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Kuusisto
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics*; D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D015716:Electrocardiography, Ambulatory; D005260:Female; D006329:Heart Conduction System / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging*; D000099163:Myosin Binding Protein C
chemical_list: D002352:Carrier Proteins; D000099163:Myosin Binding Protein C
keywords: Arrhythmia; cardiac magnetic resonance; echocardiography; risk assessment; speckle tracking; sudden cardiac death