Contraction alterations in Brugada syndrome; association with life-threatening ventricular arrhythmias

Autor: Carlo de Asmundis, Sophie Van Malderen, Bernard Cosyns, Juan Sieira, Steven Droogmans, Gian-Battista Chierchia, Øyvind H. Lie, Pedro Brugada, Andreea Motoc, Esther Scheirlynck
Přispěvatelé: Clinical sciences, Surgical clinical sciences, Internal Medicine, Faculty of Medicine and Pharmacy, Cardiology, Heartrhythmmanagement, Cardio-vascular diseases
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Heart Ventricles
medicine.medical_treatment
Speckle tracking echocardiography
030204 cardiovascular system & hematology
Ventricular tachycardia
Risk Assessment
sudden cardiac death
RISK STRATIFICATION
Sudden cardiac death
Electrocardiography
03 medical and health sciences
0302 clinical medicine
SPECKLE TRACKING ECHOCARDIOGRAPHY
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Brugada Syndrome
Brugada syndrome
Ejection fraction
business.industry
fungi
Middle Aged
Prognosis
Implantable cardioverter-defibrillator
medicine.disease
Myocardial Contraction
Biomechanical Phenomena
Death
Sudden
Cardiac
medicine.anatomical_structure
Echocardiography
Ventricle
Ventricular fibrillation
Ventricular arrhythmia
Tachycardia
Ventricular
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: International Journal of Cardiology. 299:147-152
ISSN: 0167-5273
Popis: Background Brugada syndrome (BrS) is characterized by a high risk of sudden cardiac death. The clinical value of deformation imaging in patients with BrS is unknown. We aimed to assess whether echocardiographic speckle tracking parameters differ between: 1) BrS patients and healthy controls, 2) BrS patients with and without life-threatening ventricular arrhythmias. Methods Left ventricle (LV) and right ventricle (RV) longitudinal strain and mechanical dispersion (MD) were derived from echocardiography at inclusion. Clinical and ECG data were retrospectively assessed. A life-threatening ventricular arrhythmia was defined as an aborted cardiac arrest or sustained ventricular tachyarrhythmia. Results We included 175 BrS patients and 82 controls. LV and RV longitudinal strain were lower (−18.1 ± 2.6% vs. −18.8 ± 2.0%, p = 0.01 and − 24.4 ± 5.4% vs. 25.6 ± 3.7%, p = 0.04), while MD was higher [38 ± 11 ms vs. 33 ± 8 ms, p = 0.001 and 15 (8–25) ms vs. 11 (6–19) ms, p = 0.03] in BrS patients compared to controls. BrS patients who experienced a life-threatening ventricular arrhythmia (n = 19) had higher LV MD compared to those without events (43 ± 11 ms vs. 37 ± 11 ms, p = 0.02). An LV MD ≥40 ms was optimally associated with life-threatening ventricular arrhythmias [odds ratio 4.62 (95%CI 1.58–13.50), p = 0.005]. Conclusions BrS patients had lower longitudinal strain and more heterogeneous contractions than healthy controls. Furthermore, BrS patients with a history of life-threatening ventricular arrhythmia had more heterogeneous LV contractions than those without. Therefore, LV MD may be a risk marker in BrS and its evaluation in prospective studies is needed.
Databáze: OpenAIRE
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