Systolic Dyssynchrony Index in Hypertrophic Cardiomyopathy: Association With Ventricular Arrhythmias and Risk Prediction.

JACC. Asia Pub Date : 2025-06-06 DOI:10.1016/j.jacasi.2025.05.002

Rong Wang, Haiming Zhuang, Nan Xu, Li Zhang, Jiayi Xing, Tingting Zhang, Lianming Kang, Lei Song, Kunjing Pang

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Abstract

Background: Mechanical dispersion (MD) has been demonstrated to be associated with nonsustained ventricular tachycardia (NSVT) and could potentially predict sudden cardiac death in hypertrophic cardiomyopathy (HCM) patients.

Objectives: The authors sought to evaluate the systolic dyssynchrony index (SDI) measured with 3-dimensional echocardiography and explore its predictive value for risk assessment in HCM patients.

Methods: A total of 610 HCM patients were prospectively enrolled, and we measured the MD and SDI. Their associations with NSVT and guideline-based implantable cardioverter-defibrillator class of recommendation (ICD-COR) were analyzed.

Results: A total of 81 (13.28%) patients were diagnosed with NSVT by the 24-hour Holter monitoring. The SDI of HCM patients with NSVT was significantly higher than that of HCM patients without NSVT (8.60% (7.00%-10.80%) vs. 6.00% (4.70%-7.15%). P = 0.000). The SDI was independently associated with the presence of NSVT (OR: 1.57; P = 0.000). The SDI identified NSVT in HCM patients with an area under the curve of 0.79 at a cutoff value of 7.58%, which was significantly higher than MD, with an area under the curve of 0.70 (P = 0.025). The percentages for class IIa ICD-COR in HCM patients with SDI ≥7.58% were significantly higher than those in HCM patients with SDI <7.58% according the current guidelines.

Conclusions: The SDI was more capable of assessing mechanical dyssynchrony and detecting NSVT in HCM patients compared with MD. The SDI might serve to identify HCM patients eligible for class IIa ICD-COR according to current guidelines.

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肥厚性心肌病的收缩非同步化指数：与室性心律失常和风险预测的关系。

背景：机械弥散度（MD）已被证明与非持续性室性心动过速（NSVT）相关，并可能预测肥厚性心肌病（HCM）患者的心源性猝死。目的：评价三维超声心动图测量的收缩期非同步化指数（SDI），探讨其对HCM患者风险评估的预测价值。方法：共纳入610例HCM患者，我们测量了MD和SDI。分析了它们与非svt和基于指南的植入式心律转复除颤器推荐等级（ICD-COR）的关联。结果：通过24小时动态心电图监测，81例（13.28%）患者诊断为非svt。HCM合并非svt患者的SDI显著高于未合并非svt的HCM患者(8.60% (7.00% ~ 10.80%)vs. 6.00%（4.70% ~ 7.15%）。P = 0.000)。SDI与非svt存在独立相关(OR: 1.57；P = 0.000)。SDI识别HCM患者的NSVT曲线下面积为0.79，截断值为7.58%，显著高于MD的曲线下面积为0.70 （P = 0.025）。结论：与MD相比，SDI更能评估HCM患者的机械不同步运动和检测非svt。根据现行指南，SDI可能有助于确定符合IIa级ICD-COR标准的HCM患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Asia Cardiology and Cardiovascular Medicine

CiteScore

4.00

自引率

0.00%

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