Mechanical Dispersion Discriminates Between Arrhythmic and Nonarrhythmic Sudden Death: From the POST SCD Study.
Mechanical Dispersion Discriminates Between Arrhythmic and Nonarrhythmic Sudden Death: From the POST SCD Study.
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机械弥散区分心律失常性和非心律失常性猝死：来自 POST SCD 研究。
DOI：
10.1016/j.jacep.2024.01.002
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Delling,FrancescaN
中科院分区：
文献类型：
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作者：
Tastet,Lionel;Ramakrishna,Satvik;Lim,LisaJ;Bibby,Dwight;Olgin,JeffreyE;Connolly,AndrewJ;Moffatt,Ellen;Tseng,ZianH;Delling,FrancescaN
心脏性猝死（SCD）的真正负担、预测因素和潜在机制，特别是可通过植入式心脏复律除颤器挽救的心律失常性猝死（SAD），仍然难以捉摸，因为只有少数院外死亡经过尸检证实。 1 POST SCD（心脏性猝死的死后系统调查）研究是第一个针对所有假定的 SCD 的前瞻性全县范围研究，并证明按照传统标准定义的 SCD 中只有一半是真正的 SAD。 1SCD 风险与心肌疤痕负担密切相关，可通过心脏磁共振进行评估。 2 然而，尚不确定使用超声心动图参数作为纤维化的替代标志物是否可以增强 SCD 的风险分层。斑点追踪超声心动图 (STE) 可详细评估左心室 (LV) 整体纵向应变 (LV-GLS) 和机械色散 (MD)，这是心肌节段不均匀收缩的一种测量方法。 MD 与潜在纤维化情况下心律失常事件的风险增加有关，与左心室射血分数无关
The true burden, predictors, and underlying mechanisms of sudden cardiac death (SCD), in particular sudden arrhythmic death (SAD) potentially rescuable with implantable cardioverter-defibrillators, remain elusive because only a minority of out-of-hospital deaths are confirmed by autopsy. 1 The POST SCD (POstmortem Systematic InvesTigation of Sudden Cardiac Death) study was the first prospective countywide study of all presumed SCDs and demonstrated that only one-half of SCDs defined by conventional criteria were true SADs. 1The risk of SCD strongly relates to the myocardial scar burden, which can be assessed by cardiac magnetic resonance. 2 However, it is uncertain whether using echocardiographic parameters as surrogate markers of fibrosis could enhance risk stratification of SCD. Speckle tracking echocardiography (STE) provides detailed assessment of left ventricular (LV) global longitudinal strain (LV-GLS) and mechanical dispersion (MD), a measure of heterogeneous contraction of myocardial segments. MD is linked to an increased risk of arrhythmic events in conditions with underlying fibrosis independent of left ventricular ejection fraction