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May 28, 20230 citationsOpen Access

Mechanical Dispersion Discriminates between Arrhythmic and Non-Arrhythmic Sudden Death: From the POST SCD Study

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Why the study?

Does mechanical dispersion and LV-GLS on pre-mortem echocardiography discriminate between arrhythmic and non-arrhythmic sudden cardiac death?

Population

65 adults with presumed sudden cardiac death who underwent comprehensive autopsy and had pre-mortem…

Comparison

Pre-mortem speckle-tracking echocardiography to… vs Comparison between autopsy-confirmed sudden…

Design

Cohort

Follow-up

mean 1.5 years

Key result

Increased mechanical dispersion was independently associated with autopsy-confirmed sudden arrhythmic death (OR 1.69) and correlated with higher histologic levels of left ventricular fibrosis.

Authors

LTLionel TastetSRSatvik RamakrishnaLLLisa J. Lim

Discussion

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Overview

May refine arrhythmic SCD risk assessment beyond LVEF; leaves open prospective validation before clinical adoption.

Study Design

Type

Observational (n=65)

Multicenter

No

Structured PICO

Does mechanical dispersion and LV-GLS on pre-mortem echocardiography discriminate between arrhythmic and non-arrhythmic sudden cardiac death?

P
Population
65 adults aged 18-90 with presumed sudden cardiac death and available premortem echocardiograms, who underwent comprehensive autopsy to adjudicate arrhythmic versus non-arrhythmic cause of death.
E
Exposure
Pre-mortem speckle-tracking echocardiography to assess left ventricular global longitudinal strain (LV-GLS) and mechanical dispersion (MD).
C
Comparator
Comparison between autopsy-confirmed sudden arrhythmic death (SAD) and non-arrhythmic sudden death (non-SAD).
O
Outcome
Autopsy-defined sudden arrhythmic death (SAD) and extent of histological LV myocardial fibrosis.surrogate

Mechanical dispersion on speckle-tracking echocardiography is a non-invasive surrogate for myocardial fibrosis that can independently discriminate true arrhythmic sudden death from non-arrhythmic causes better than LVEF.

Main Result

Odds Ratio: 1.69 (95% CI 1.06–2.68)

p-value: p=0.03

Limitations

  • Only 10% (65 of 652) of autopsied subjects had echocardiograms available with adequate image quality for primary review.
  • Characterization of left ventricular myocardial fibrosis was available in only 58% (38 of 65) of cases.

Cite This Study

Tastet et al. (2023) conducted an observational in Presumed Sudden Cardiac Death (SCD) (n=65). Increased mechanical dispersion was evaluated on Autopsy-defined sudden arrhythmic death (SAD) (OR 1.69, 95% CI 1.06-2.68, p=0.03). Increased mechanical dispersion was independently associated with autopsy-confirmed sudden arrhythmic death (OR 1.69) and correlated with higher histologic levels of left ventricular fibrosis.

synapsesocial.com/papers/6aa59f13041e43fea73a5bc7https://doi.org/10.1101/2023.05.22.23290353
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