Page 152 - The role of advanced echocardiography in patients with ischemic heart disease - Rachid Abou

ABSTRACT
Left ventricular (LV) mechanical dispersion (MD) may result from heterogeneous electrical conduction and is associated with adverse events. The present study investigated 1) the association between LV MD and the extent of LV scar as assessed with contrast enhanced cardiac magnetic resonance (CMR) and 2) the prognostic implications of LV MD in patients after ST-segment elevation myocardial infarction. LV MD was calculated by echocardiography and myocardial scar was analyzed on CMR data retrospectively. Infarct core and border zone were defined as ≥50% and 35%-50% of maximal signal intensity, respectively. Patients were followed for the occurrence of the combined endpoint (all-cause mortality and appropriate implantable cardioverter defibrillator therapy). In total, 96 patients (87% male, 57±10 years) were included. Median LV MD was 53.5 ms (IQR 43.4-62.8). On CMR, total scar burden was 11.4% (IQR 3.8-17.1%), infarct core tissue 6.2% (IQR 2.0-12.7%) and border zone was 3.5% (IQR 1.5-5.7%). Correlations were observed between LV MD and infarct core (r=0.517, p<0.001), total scar burden (r=0.497, p<0.001) and border zone (r=0.298, p=0.003). In total, 14 patients (15%) reached the combined endpoint. Patients with LV MD >53.5 ms showed higher event rates as compared to their counterparts. Finally, LV MD showed the highest area under the curve for the prediction of the combined endpoint. LV MD is correlated with LV scar burden. In addition, patients with prolonged LV MD showed higher event rates. Finally, LV MD provided the highest predictive value for the combined endpoint when compared to other parameters.