Key result
Mechanical dispersion is linked to ~16% higher MACE risk per SD in middle-aged adults.
Why the study?
While global longitudinal strain and mechanical dispersion add prognostic value in cardiac disease, their prognostic relevance for incident MACE and all-cause mortality in the general population remained uncertain.
Does global longitudinal strain and mechanical dispersion assessed by speckle-tracking echocardiography predict incident major adverse cardiovascular events and all-cause mortality in a middle-aged general population?
Cohort (n=2,495)
Does global longitudinal strain and mechanical dispersion assessed by speckle-tracking echocardiography predict incident major adverse cardiovascular events and all-cause mortality in a middle-aged general population?
In a middle-aged general population, lower global longitudinal strain and higher mechanical dispersion predict incident cardiovascular events, with mechanical dispersion offering incremental prognostic value beyond conventional risk factors and left ventricular ejection fraction.
Mechanical dispersion was associated with incident MACE beyond standard factors; leaves open its incremental value for risk stratification in middle-aged adults.
Background Global longitudinal strain (GLS) reflects subclinical left ventricular dysfunction and has been linked to adverse outcomes in selected populations. Mechanical dispersion (MD), reflecting mechanical heterogeneity, adds prognostic value in cardiac disease, but its prognostic relevance in the general population remains uncertain. Purpose To investigate associations of GLS and MD with incident major adverse cardiovascular events (MACE) and all-cause mortality in a population-based cohort. Methods The ACE1950 Study enrolled 3,706 individuals born in 1950 between 2013 and 2015. Among these, 2,495 participants with complete strain and covariate data were analyzed. GLS and MD were assessed by speckle-tracking echocardiography. Participants were followed until December 31 st , 2022, for incident MACE (myocardial infarction, stroke, heart failure, or coronary revascularization) and all-cause mortality. Multivariable Cox regression models adjusted for cardiovascular risk factors and left ventricular ejection fraction were applied. Non-linearity of GLS was assessed using restricted cubic splines. Results Over a median follow-up of 8.3 years, 180 MACE and 118 deaths occurred. GLS demonstrated a non-linear association with MACE, with increased risk confined to lower strain values. MD was independently associated with MACE (HR 1.16 per SD increase, 95% CI 1.01–1.33; p=0.034) and improved model fit beyond risk factors, ejection fraction, and GLS (likelihood-ratio p=0.016). Associations were weaker after adjustment for prevalent coronary artery disease. Neither GLS nor MD were associated with all-cause mortality. Conclusion In this middle-aged general population, lower GLS values were associated with incident cardiovascular events. MD provided incremental prognostic information beyond conventional risk markers and ejection fraction.Association between GLS and MACE
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Koch et al. (2026) conducted a cohort in Subclinical left ventricular dysfunction and incident cardiovascular events in the general population (n=2,495). Global longitudinal strain (GLS) and mechanical dispersion (MD) vs. Lower mechanical dispersion / normal strain values (continuous exposure per SD increase) was evaluated on Incident major adverse cardiovascular events (MACE: myocardial infarction, stroke, heart failure, or coronary revascularization) and all-cause mortality (HR 1.16 per SD increase in MD, 95% CI 1.01-1.33, p=0.034). Mechanical dispersion independently predicted MACE (HR 1.16 per SD, 95% CI 1.01-1.33; p=0.034) and lower GLS showed a non-linear association with MACE in a middle-aged cohort.
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