Left ventricular mechanical dispersion measured by two dimensional speckle tracking echocardiography (MD) is a novel strain derived parameter that reflects temporal cardiac contraction heterogeneity and has consequently gained attention as a predictor of increased arrhythmic risk in selected cardiac diseases.

LV mechanical dispersion along with LV GLS may provide additional valuable risk markers of VA and SCD in pre dialysis and dialysis patients [1,2]. Mechanical dispersion by strain echocardiography may be a marker of ventricular arrhythmias beyond EF. Mechanical dispersion was increased in those with any arrhythmic events (nsVT or sustained VT) vs. patients free of arrhythmic events [3,4]. Mechanical dispersion was pronounced in patients after TAVI. Mechanical dispersion was independently associated with mortality and could confer additional risk requiring closer post procedural follow-up [5]. LV mechanical dispersion assessed by speckle tracking echocardiography increases significantly with severity of AS and is significantly associated with all-cause mortality. However, LVEF may not recover after AVR and patients may remain symptomatic. Speckle tracking echocardiographic parameters of LV shortening and mechanical dispersion have been proposed to detect LV systolic dysfunction at an earlier stage than LVEF and are related to the presence of myocardial fibrosis on cardiac magnetic resonance [6]. There is increasing interest in assessment of left ventricular mechanical dispersion but normal data are limited