Literature DB >> 31202762

Prediction of Ventricular Arrhythmias With Left Ventricular Mechanical Dispersion: A Systematic Review and Meta-Analysis.

Hiroshi Kawakami1, Nitesh Nerlekar1, Kristina H Haugaa2, Thor Edvardsen2, Thomas H Marwick3.   

Abstract

OBJECTIVES: The aim of this study was to assess the association between left ventricular mechanical dispersion (LVMD) and the incidence of ventricular arrhythmias (VAs).
BACKGROUND: Recent, mainly single-center, studies have demonstrated that LVMD assessed using speckle tracking might be a powerful marker in risk stratification for VA. A systematic review and meta-analysis provides a means of understanding the prognostic value of this parameter, relative to other parameters, the most appropriate cutoff for designating risk.
METHODS: A systemic review of studies reporting the predictive value of LVMD for VA was undertaken from a search of MEDLINE and Embase. VA events were defined as sudden cardiac death, cardiac arrest, documented ventricular tachyarrhythmia, and appropriate implantable cardioverter-defibrillator (ICD) therapy. Hazard ratios were extracted from univariate and multivariate models reporting on the association of LVMD and VA and described as pooled estimates with 95% confidence intervals. In a meta-analysis, the predictive value of LVMD was compared with that of left ventricular ejection fraction and global longitudinal strain.
RESULTS: Among 3,198 patients in 12 published studies, 387 (12%) had VA events over follow-up ranging from 17 to 70 months. Patients with VAs had greater LVMD than those without (weighted mean difference -20.3 ms; 95% confidence interval: -27.3 to -13.2; p < 0.01). Each 10 ms increment of LVMD was significantly and independently associated with VA events (hazard ratio: 1.19; 95% confidence interval: 1.09 to 1.29; p < 0.01). The predictive value of LVMD was superior to that of left ventricular ejection fraction or global longitudinal strain.
CONCLUSIONS: LVMD assessed using speckle tracking provides important predictive value for VA in patients with a number of cardiac diseases and appears to have superior predictive value over left ventricular ejection fraction and global longitudinal strain for risk stratification.
Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  mechanical dispersion; meta-analysis; strain; ventricular arrhythmia

Year:  2019        PMID: 31202762     DOI: 10.1016/j.jcmg.2019.03.025

Source DB:  PubMed          Journal:  JACC Cardiovasc Imaging        ISSN: 1876-7591


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