Abstract 16058: Association Between Global Electrical Heterogeneity and Left Ventricular Mechanical Dyssynchrony in the General Population - The Atherosclerosis Risk in Communities Study
Introduction: ECG parameters reflecting global electrical heterogeneity (GEH) (QRS-T angle, spatial ventricular gradient magnitude (SVGmag), azimuth (SVGazi), and elevation (SVGelv), and sum absolute QRST integral (SAI QRST)), independently reflect cardiac electrophysiological substrate associated with sudden cardiac death. SAI QRST has also been associated with response to cardiac resynchronization therapy. The association between GEH parameters and mechanical dyssynchrony as assed by echocardiography is unknown.
Hypothesis: We hypothesized that GEH ECG parameters, especially SAI QRST, would be associated with mechanical dyssynchrony.
Methods: In the Atherosclerosis Risk in Communities study (n= 5,387; age 76 yrs; 42% male; 78% white) GEH ECG parameters were measured on standard 12-lead ECGs. Mechanical dyssynchrony was quantified by the standard deviation of the time to peak longitudinal strain (SD T2P LS) in 12 LV segments in the apical 4 chamber and 2 chamber views by speckle-tracking echocardiography. Regression models and standardized beta coefficients assessed associations between GEH ECG parameters and T2P LS.
Results: For every 10 unit increase in QRS-T angle, SAI QRST, sqrtSVGazi and sqrtSVGelv, the T2P LD increased by 1.55 (1.29-1.81), 0.93 (0.79-1.07), 21.78 (17.87-25.69) and 34.76 (26.57-42.95) msec, respectively (Figure). After multivariable adjustment for age, sex, race, BMI, coronary heart disease, heart failure, hypertension, diabetes, smoking, heart rate, and blood pressure, GEH parameters remained independently associated with T2P LD. Standardized beta coefficients revealed that SAI QRST had the strongest association with T2P LS (Figure) with a beta coefficient that was higher than that for QRS duration (Figure).
Conclusion: GEH ECG parameters are significantly associated with cardiac mechanical dyssynchrony. SAI QRST had the strongest association with mechanical dyssynchrony and performed better than QRS duration.
Author Disclosures: T. Biering-Sørensen: None. J.W. Waks: None. M. Kabir: None. C.A. Henrikson: Other; Significant; St Jude, Medtronic, Boston Scientific. W.S. Post: None. E.Z. Soliman: None. A.E. Buxton: Research Grant; Significant; Medtronic research grant; not in this subject area. M.E. Josephson: None. A.M. Shah: None. S.D. Solomon: Research Grant; Significant; Novartis, Amgen. Consultant/Advisory Board; Modest; Novartis. L.G. Tereshchenko: Research Grant; Significant; Medtronic, inc, Boston Scientific. Consultant/Advisory Board; Significant; Medtronic, inc.
- © 2016 by American Heart Association, Inc.