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January 4, 2025BMC Cardiovascular DisordersOpen Access

Magnetic resonance imaging quantification of left ventricular mechanical dispersion and scar heterogeneity optimize risk stratification after myocardial infarction

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Why the study?

Limited research has investigated left ventricular mechanical dispersion following myocardial infarction, prompting this study to assess its prognostic value and correlation with myocardial scar heterogeneity.

Does CMR-derived left ventricular mechanical dispersion (LVMD) predict the composite of sudden cardiac death, sustained ventricular arrhythmias, and new-onset heart failure in post-myocardial infarction patients?

Population

181 post-MI patients undergoing CMR

Comparison

CMR-derived LVMD and border zone entropy for adverse clinical outcomes

Design

Observational cohort study

Follow-up

Median 31 months

Key result

Cardiac magnetic resonance-derived left ventricular mechanical dispersion independently predicted the primary composite endpoint of sudden cardiac death, sustained ventricular arrhythmias, and new-onset heart failure in post-myocardial infarction patients (HR 1.014).

Authors

XZXiaoying ZhaoLZLi ZhangLWLujing Wang

Discussion

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Overview

Hypothesis-generating for CMR-derived LVMD in post-MI risk stratification; prospective trials needed before clinical adoption.

Study Design

Type

Cohort (n=181)

Multicenter

No

Structured PICO

Does CMR-derived left ventricular mechanical dispersion (LVMD) predict the composite of sudden cardiac death, sustained ventricular arrhythmias, and new-onset heart failure in post-myocardial infarction patients?

P
Population
181 post-myocardial infarction patients (median age 55.7 years, 76.8% male) with previous MI >3 months ago and NYHA class ≤ III, undergoing CMR examination.
I
Intervention
Cardiac magnetic resonance (CMR)-derived left ventricular mechanical dispersion (LVMD) and border zone (BZ) entropy assessment
O
Outcome
Composite of sudden cardiac death (SCD), sustained ventricular arrhythmias (VA), and new-onset heart failure (HF) over a median follow-up of 31 monthscomposite

Main Result

Effect estimate: HR 1.014 (95% CI 1.003-1.024)

p-value: p=0.010

CMR-derived left ventricular mechanical dispersion and border zone entropy are independent predictors of adverse outcomes after myocardial infarction, improving risk stratification beyond LVEF alone.

Limitations

  • Single-center, observational study with a relatively small sample size
  • Unable to further discuss the specific events at different endpoints due to limited sample size
  • Correlation coefficient between LVMD and entropy parameters is small, requiring further validation
  • Did not compare LVMD measurements obtained by CMR with those obtained by echocardiography

Cite This Study

Zhao et al. (2025) conducted a cohort in Myocardial Infarction (n=181). Cardiac magnetic resonance-derived left ventricular mechanical dispersion (LVMD) was evaluated on Composite of sudden cardiac death, sustained ventricular arrhythmias or/and ICD implantation, and new-onset heart failure (HR 1.014, 95% CI 1.003-1.024, p=0.010). Cardiac magnetic resonance-derived left ventricular mechanical dispersion independently predicted the primary composite endpoint of sudden cardiac death, sustained ventricular arrhythmias, and new-onset heart failure in post-myocardial infarction patients (HR 1.014).

synapsesocial.com/papers/6a18abdc673175fe754ac2b5https://doi.org/10.1186/s12872-024-04451-4
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