Department of Cardiology, Universitair Ziekenhuis Brussel, Centrum voor Hart- en Vaatziekten, Brussels, Belgium; Life sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.
Life sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.
Int J Cardiol. 2020 Jan 15;299:147-152. doi: 10.1016/j.ijcard.2019.06.074. Epub 2019 Jun 30.
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.
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.
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].
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.
Brugada 综合征（BrS）的特征是心脏性猝死风险较高。目前尚不清楚超声心动图斑点追踪参数在 BrS 患者中的临床价值。我们旨在评估：1）BrS 患者与健康对照组之间，2）BrS 患者有无致命性室性心律失常之间，超声心动图斑点追踪参数是否存在差异。
在纳入时，从超声心动图中得出左心室（LV）和右心室（RV）纵向应变和机械弥散（MD）。回顾性评估临床和心电图数据。致命性室性心律失常定义为心脏骤停中止或持续性室性心动过速。
我们纳入了 175 例 BrS 患者和 82 例对照组。LV 和 RV 纵向应变更低（-18.1±2.6% vs. -18.8±2.0%，p=0.01 和-24.4±5.4% vs. 25.6±3.7%，p=0.04），而 MD 更高[38±11ms vs. 33±8ms，p=0.001 和 15（8-25）ms vs. 11（6-19）ms，p=0.03]，与对照组相比，BrS 患者的 MD 更高。经历致命性室性心律失常的 BrS 患者（n=19）的 LV MD 高于无事件者（43±11ms vs. 37±11ms，p=0.02）。LV MD≥40ms 与致命性室性心律失常最佳相关[比值比 4.62（95%CI 1.58-13.50），p=0.005]。
与健康对照组相比，BrS 患者的纵向应变更低，收缩更不均匀。此外，有致命性室性心律失常史的 BrS 患者的 LV 收缩更不均匀。因此，LV MD 可能是 BrS 的风险标志物，需要在前瞻性研究中评估。
