Multiparametric Echocardiographic Assessment for Myocardial Function in Idiopathic Ventricular Fibrillation Patients
[Objective]To explore echocardiographic features in idiopathic ventricular fibrillation(IVF)patients by multiparametric echocardiographic assessment,in order to evaluate the feasibility of identifying patients at high risk of ven-tricular arrhythmia using echocardiography.[Methods]Patients diagnosed with IVF for the first time in Sun Yat-sen Memo-rial Hospital from January 2019 to December 2023 were included.Age-and sex-matched healthy individuals were includ-ed as control.Multiparametric echocardiographic assessment was performed,involving conventional parameters,myocardi-al mechanical movement parameters,electro-mechanical parameters,and myocardial energetic parameters.Continuous variables were compared using independent samples t-test or Mann-Whitney U test.The receiver operating characteristic(ROC)curves were performed for echocardiographic parameters to assess their diagnostic value for IVF.The intraclass cor-relation coefficient(ICC)was used to assess the inter-observer and intra-observer variability.[Results]Nine patients with IVF and thirty healthy individuals were included in this study.In total,702 left ventricular segments and 117 right ventric-ular free wall segments were analyzed for myocardial function.Left ventricular global longitudinal strain(LV-GLS)was lower in IVF group than in the control group[(18.8±2.7)%vs.(21.2±1.9)%,P=0.004].Left ventricular mechanical dis-persion(LV-MD)was higher in IVF group than in the control group[(44±13)ms vs.(36±9)ms,P=0.022].Global work index(GWI)was lower in IVF group than in the control group[(1991±365)mmHg%vs.(2319±408)mmHg%,P=0.037].Based on the results of the ROC curve test,LV-GLS,LV-MD and GWI had the better diagnostic performance,with the area under the curve(AUC)of 0.748,0.737 and 0.722,the cutoff value of 19.5%,39.5ms and 2049mmHg%,re-spectively.The combination of three indices had the largest AUC value of 0.800.All echocardiographic parameters had ex-cellent intra-observer repeatability and inter-observer reproducibility.The ICC for all parameters was higher than 0.75.[Conclusion]Our results show variable degrees of left ventricular dysfunction are observed in IVF patients by multipara-metric echocardiographic assessment.Decreased LV-GLS,increased LV-MD and decreased GWI are considered high-risk echocardiographic features for malignant arrhythmia.
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