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February 2, 2026European Heart Journal - Cardiovascular Imaging

Clinical correlates and prognostic significance of mechanical dispersion across genotypes in dilated cardiomyopathy

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Why the study?

Mechanical dispersion predicts arrhythmic risk in cardiomyopathies, but limited data exist comparing it across different genetic subtypes.

Does mechanical dispersion differ between DSP/FLNC and TTN mutation carriers, and does it predict ventricular arrhythmias in genetic cardiomyopathy?

Population

48 patients with genetic cardiomyopathy harboring pathogenic or likely pathogenic DSP, FLNC, or TTN variants

Comparison

DSP/FLNC mutations vs TTN mutations

Design

Prospective cohort study

Key result

Mechanical dispersion did not significantly differ between DSP/FLNC and TTN mutation carriers (66.0 vs 70.8 ms; p=0.468), but was a strong predictor of ventricular arrhythmias (AUC 0.728).

Authors

AAA ApostuBIB IonescuRAR Adam

Discussion

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Overview

May support arrhythmia risk stratification in genetic cardiomyopathy; extends observational data but leaves open prospective validation.

Key Points

  • Evaluate mechanical dispersion differences between patients with DSP/FLNC and TTN mutations, and its relationship with clinical variables.
  • Enrolled 48 genetic cardiomyopathy patients with DSP, FLNC, or TTN variants.
  • Divided patients into groups based on genotype: TTN (24) and DSP/FLNC (24).
  • Assessed ventricular arrhythmias, myocardial fibrosis via late gadolinium enhancement on MRI, and left ventricle function.
  • No significant age or sex differences between genotype groups.
  • TTN mutation carriers had lower prevalence of late gadolinium enhancement compared to DSP/FLNC (41.7% vs 75%).
  • Mechanical dispersion did not significantly differ between DSP/FLNC (66.0 ms) and TTN (70.8 ms) groups.
  • Higher mechanical dispersion associated with ventricular arrhythmias, LGE, ICD implantation, and NYHA class III–IV.
  • Mechanical dispersion showed strong predictive ability for arrhythmias (AUC = 0.728).

Study Design

Type

Cohort (n=48)

Multicenter

No

Structured PICO

Does mechanical dispersion differ between DSP/FLNC and TTN mutation carriers, and does it predict ventricular arrhythmias in genetic cardiomyopathy?

P
Population
48 patients with genetic cardiomyopathy harboring pathogenic or likely pathogenic DSP, FLNC, or TTN variants evaluated at a single center.
E
Exposure
DSP/FLNC mutations
C
Comparator
TTN mutations
O
Outcome
Differences in mechanical dispersion (MD) between genotypes, and the relationship of MD with ventricular arrhythmias, myocardial fibrosis (LGE), and left ventricular function.surrogate

Main Result

Absolute Event Rate: 66% vs 70.8%

p-value: p=0.468

Mechanical dispersion is a strong, non-invasive predictor of ventricular arrhythmias in genetic cardiomyopathies that outperforms LVEF and GLS, regardless of the underlying genotype.

Cite This Study

Apostu et al. (2026) conducted a cohort in Genetic cardiomyopathy (dilated cardiomyopathy) (n=48). DSP/FLNC mutations vs. TTN mutations was evaluated on Mechanical dispersion (MD) (p=0.468). Mechanical dispersion did not significantly differ between DSP/FLNC and TTN mutation carriers (66.0 vs 70.8 ms; p=0.468), but was a strong predictor of ventricular arrhythmias (AUC 0.728).

synapsesocial.com/papers/6980ff49c1c9540dea812205https://doi.org/10.1093/ehjci/jeaf367.295
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