Left ventricular mechanical dispersion in a general population: Data from the Akershus Cardiac Examination 1950 study

Author:

Aagaard Erika N12,Kvisvik Brede12,Pervez Mohammad O12,Lyngbakken Magnus N12,Berge Trygve23,Enger Steve3,Orstad Eivind B1,Smith Pål12,Omland Torbjørn12,Tveit Arnljot23,Røsjø Helge12,Steine Kjetil12ORCID

Affiliation:

1. Department of Cardiology, Division of Medicine, Akershus University Hospital, Postbox 1000, 1478 Lørenskog, Norway

2. Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Postbox 1078 Blindern, 0316 Oslo, Norway

3. Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Postbox 800, 3004 Drammen, Norway

Abstract

Abstract Aims Increased left ventricular mechanical dispersion by 2D speckle tracking echocardiography predicts ventricular arrhythmias in ischaemic heart disease and heart failure. However, little is known about mechanical dispersion in the general population. We aimed to study mechanical dispersion in the general population and in diseases associated with increased risk of cardiovascular disease. Methods and results The present cross-sectional study consists of 2529 subjects born in 1950 included in the Akershus Cardiac Examination (ACE) 1950 study. Global longitudinal strain (GLS) was assessed from 17 strain segments, and mechanical dispersion calculated as the standard deviation of contraction duration of all segments. The cohort was divided according to the median value of mechanical dispersion, and multivariable linear regression models were performed with mechanical dispersion as the dependent variable. The prevalence of coronary artery disease (CAD), hypertension, obesity, and diabetes (P < 0.01 for all) was significantly higher in subjects with supra-median mechanical dispersion. In a multivariable clinical model, CAD (B = 7.05), hypertension (B = 4.15; both P < 0.001), diabetes (B = 3.39), and obesity (B = 1.89; both P < 0.05) were independently associated with increasing mechanical dispersion. When echocardiographic indices were added to the multivariable model, CAD (B = 4.38; P < 0.01) and hypertension (B = 2.86; P < 0.001) remained significant in addition to peak early diastolic tissue velocity e’ (B = −2.00), GLS (B = 1.68), and ejection fraction (B = 0.22; P < 0.001 for all). Conclusion In a general middle-aged population, prevalent CAD and hypertension were associated with increasing mechanical dispersion, possibly indicating elevated risk of fatal arrhythmias and sudden cardiac death. Albeit weaker, systolic and diastolic dysfunction, were also associated with increasing mechanical dispersion.

Funder

South-Eastern Norway Regional Health Authority

Akershus University Hospital Trust

Vestre Viken Hospital Trust

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine

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