Abstract 16289: Global Strain by Strain Echocardiography May Help Risk Stratification of Ventricular Arrhythmias in Patients With Non Ischemic Dilated Cardiomyopathy
Background: Risk prediction of ventricular arrhythmias in patients with non ischemic dilated cardiomyopathy (DCM) is challenging. Guidelines for ICD and CRT-D indications are based on LV ejection fraction (EF) and QRS duration although they are insufficient in arrhythmic risk prediction. Myocardial strain by echocardiography can accurately quantify ventricular function. We therefore hypothesized that global strain may be a marker of ventricular arrhythmias in patients with DCM.
Methods: In all, 58 patients with non ischemic DCM were investigated with strain echocardiography. Of these, 11 had arrhythmic events defined as sustained VT or cardiac arrest. QRS duration was recorded from ECG. By speckle tracking echocardiography, global strain was calculated as average peak negative strain from a 16 LV segments model. LVEF and body surface corrected LV mass were assessed from standard echocardiography.
Results: Global strain was reduced in DCM patients with arrhythmic events compared to those without (−7.2±5.9% vs. −12.2±5.9%, p=0.02). DCM patients with arrhythmias had higher LV mass and prolonged QRS compared to those without (184±55 g/m2 vs. 149±43g/m2, p=0.03 and 134±39ms vs. 96±31ms, p=0.002). EF did not differentiate between those with and without arrhythmic events (35±16% vs. 41±16%, p=0.28).
Conclusions: Global strain, LV mass and QRS duration were markers of arrhythmias in patients with DCM, while EF was not. Global strain by echocardiography may provide added value in risk assessment of ventricular arrhythmias in DCM patients.
- © 2010 by American Heart Association, Inc.