P366 Role of mechanical dispersion in the prediction of heart failure admissions in dilated non ischemic cardiomyopathy

Abstract

Abstract Introduction Non ischemic dilated cardiomyopathy (DCM) is a disease with poor prognosis and limited therapeutic options. Several echocardiographic measures attempt to provide good estimators of the risk of heart failure (HF) admissions. Purpose To assess the potential additional value of mechanical dispersion (MD) compared to global longitudinal strain (GLS) in the prediction of outcomes in DCM. Methods 74 patients with DCM and left ventricle ejection fraction (LVEF) of less than 50% were prospectively evaluated from 2015 to 2019. MD and GLS were blindly measured using 2D speckle tracking echocardiography. Hospital admissions due to worsening HF were examined. Results Mean LVEF was 29.4%, and median follow-up time was 14 months. Baseline characteristics are shown in Table 1. Patients with high MD, defined as >67 ms, showed a significantly higher risk of admissions due to HF (50.5% vs 22.0%, p = 0.026), even when adjusted with LVEF and end-diastolic volume in multivariable analysis, with a hazard ratio of 2.6 (95% confidence interval 1.1-6.1) (Figure). No differences in the use of cardiac resynchronization therapy and implantable cardioverter defibrillator were observed in both groups. This cut off value had a Sensitivity of 52.2% and Specificity of 76.5%. Despite significant correlation between MD and GLS (R = 0.36, p = 0.002), a GLS of less than -10% was not significantly associated with higher incidence of HF admissions in this population (40.6% vs 23.8%, p = 0.229). Conclusion Mechanical dispersion, measured by 2D speckle tracking echocardiography, predicts HF admissions more accurately than global longitudinal strain in patients with non-ischemic DCM. Table 1 Mech. Disp <67 ms (n = 50) Mech. Disp ≥67 ms (n = 24) p Age 62.2 (±2.2) 64.6 (±3.0) 0.538 Female sex 13 (26.0%) 10 (41.7%) 0.173 NYHA class III-IV 4 (8.5%) 3 (13.6%) 0.882 CRT 23 (46.0%) 12 (50.0%) 0.747 ICD 27 (54.0%) 17 (70.0%) 0.167 QRS duration (ms) 144.2 (±8.6) 152.7 (±7.9) 0.496 NTproBNP (pg/ml) 4495 (±964) 4488 (±1529) 0.997 LVEF (%) 29.9 (±1.1) 28.6 (±1.7) 0.520 LVEDV (ml/m2) 93.0 (±5.6) 95.2 (±5.8) 0.802 Table 1: baseline characteristics in population with MD <67 ms or ≥ MS. Data is shown as N(%) or Mean(±SD). CRT: cardiac resynchronization therapy. ICD: implantable cardioverter defibrillator. LVEDV: LV end-diastolic volume. Abstract P366 Figure