The diagnostic value of 2D‐speckle tracking echocardiography for identifying subclinical ventricular dysfunction in subjects with early repolarization pattern

Abstract

Introduction Early repolarization pattern (ERP) can exist a silent substrate for arrhytmic events in accordance with the previous studies which have shown there has been evidence of morphological changes in left ventricle (LV) in ERP subjects. Despite structural changes in ERP subjects, it has not exactly known whether a change in LV functional parameters occur in ERP. The aim of our study was to investigate LV functional parameters in ERP athletes evaluated by 2D‐ speckle tracking echocardiography (2D‐STE). Method In this study, athletes with ERP (n = 50) and athletes without ERP (n = 50) were recruited between April 2018 and September 2018. For each case, 2D‐ TTE and 2D‐ STE evaluation were performed by the same cardiologist. Results Left ventricle mean global longitudinal strain (GLS) (P < .001) and GLS at all apical chamber views (P < .001), longitudinal peak systolic strain rate (SRS) at A3C (P: .011), early diastolic strain rate (SRE) at A3C (P < .001) and late diastolic strain rate (SRA) at A3C (P: .034) in the ERP athletes were significantly lower than those in the athletes without ERP. LV basal segment circumferential SRS (P: .002) and SRE (P: .006) were significantly lower in ERP athletes compared to athletes without ERP. LV mechanical dispersion was significantly higher in ERP athletes compared to athletes without ERP (P < .001). Conclusion Our study suggests ERP can be more associated with impaired LV longitudinal function than circumferential function. In addition, both LV inferolateral region and basal segment can be more affected functionally in ERP athletes.

Evaluation of cardiac electromechanics in patients with newly diagnosed hypertension

“…The possible explanations for how ERP is associated with impaired LVGLS in newly diagnosed hypertension patients are; first, as concomitant diastolic dysfunction, the increased wall stress results in LV geometrical and structural change. The ventricular strain is closely related to wall stress [25]. In agreement with our findings, several researchers found an inverse connection between wall stress and strain parameters [30,31].…”

“…Regarding ECG parameters, the relationship of ERP, PR, and QTc with LV systolic dysfunction and poor outcome are studied well in different populations [25][26][27]. However, the association of ERP with subclinical LV systolic dysfunction in newly diagnosed hypertension patients has remained concealed.…”

“…Besides, an association between ERP and impaired LVGLS also has been documented. Çöllüoğlu et al [25] demonstrated a significant association between ERP and impaired LVGLS in athletes. LVGLS was significantly lower in athletes with ERP than in athletes without ERP.…”

Cardiac Morphofunctional Characteristics of Individuals with Early Repolarization Pattern: A Literature Review

“…In the ERP+ group, the global longitudinal strain was smaller, and the strain rate, measured in the apical three-chamber view, was also smaller in the ERP+ group. The groups’ global circumferential strain and strain rate parameters were similar [ 60 ].…”