Mechanical dispersion was significantly associated with ventricular ectopic burden in non-ischemic dilated cardiomyopathy (β = 39.84; 95% CI 11.45-68.23; p=0.008), whereas age was not.
Cross-Sectional (n=28)
Do clinical, electrocardiographic, and echocardiographic parameters predict ventricular ectopic burden in patients with non-ischemic DCM?
In non-ischemic DCM, ventricular ectopic burden is primarily driven by electrical heterogeneity as reflected by mechanical dispersion on echocardiography, rather than age.
Effect estimate: β 39.84 (95% CI 11.45-68.23)
p-value: p=0.008
Abstract Background In non-ischemic dilated cardiomyopthy (DCM), ventricular ectopy is commonly present, contributes to arrhythmic risk, and may reflect underlying electrical and mechanical heterogeneity. Although advanced echocardiographic markers-including mechanical dispersion (MD), strain-derived indices, and myocardial work parameters-provide insights into myocardial electrical and mechanical instability, the extent to which age, clinical characteristics, electrocardiographic findings, and these imaging indices influence ectopic burden remains uncertain. Objective To assess whether ventricular ectopy varies with age and to explore the clinical, electrocardiographic, and echocardiographic determinants of ectopic burden in non-ischemic DCM. Methods In this pilot study, we included 28 patients with non-ischemic DCM who underwent clinical evaluation, electrocardiogram (ECG) analysis, and comprehensive echocardiography. The echocardiographic assessment included standard chamber quantification, biplane LVEF assessment, global longitudinal strain (GLS), mechanical dispersion (MD), and myocardial work indices derived from speckle-tracking imaging. Upon DCM diagnosis, ventricular ectopy was quantified using 24-hour Holter monitoring. Patients were stratified according to the cohort's median age (57 years), and all clinical, electrocardiographic, and echocardiographic variables were systematically assessed in each group. The association between these variables and the number of ventricular premature beats was evaluated using multiple regression analysis. Results The younger group had a median age of 43 years (IQR 35.7-53.0), while the older group had a median age of 67.5 years (IQR 65.9-71.3). No significant difference in ventricular ectopy was observed between age groups. Among baseline characteristics, diabetes was more frequent in older patients (p=0.034), whereas no differences were observed in other clinical, ECG, or echocardiographic parameters between age groups. In the multiple regression analysis, LVEF, GWI and MD were associated with the number of ventricular ectopic beats (Table 1), with MD showing the strongest relationship (p0,01). After adjusting models for the imaging parameters found to be associated with ectopic burden (GWI, MD), only MD remained significantly associated with ventricular ectopy (β = 39.84, 95% CI 11.45–68.23, p = 0.008), whereas GWI did not (p = 0.68). Conclusion Ventricular ectopic burden showed no meaningful variation across age groups in non-ischemic DCM, and seemed primarily driven by electrical heterogeneity, as reflected by mechanical dispersion.For image description, please refer to the figure legend and surrounding text.
Hart-Foia et al. (Mon,) conducted a cross-sectional in Non-ischemic dilated cardiomyopathy (n=28). Mechanical dispersion and age was evaluated on Number of ventricular premature beats (ventricular ectopic burden) (β 39.84, 95% CI 11.45-68.23, p=0.008). Mechanical dispersion was significantly associated with ventricular ectopic burden in non-ischemic dilated cardiomyopathy (β = 39.84; 95% CI 11.45-68.23; p=0.008), whereas age was not.