Xiuyu Chen1, Shihua Zhao2, Tao Zhao3, Minjie Lu4, Gang Yin5, Shiliang Jiang6, Sanjay Prasad7. 1. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: cxy0202@126.com. 2. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: zhaoshihua0202@126.com. 3. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: taozhao0202@126.com. 4. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: lmjkan@126.com. 5. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: gangyin0202@126.com. 6. Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: jiangsl-2011@163.com. 7. NIHR Biomedical Research Unit, Royal Brompton Hospital Sydney Street, London, SW3 6NP, United Kingdom. Electronic address: s.prasad@rbht.nhs.uk.
Abstract
OBJECTIVES: To investigate the relationship between T-wave inversions and left ventricular (LV) segmental hypertrophy and myocardial fibrosis assessed by cardiovascular magnetic resonance (CMR) in patients with non-apical hypertrophic cardiomyopathy (HCM). METHODS: 196 consecutive patients with non-apical HCM underwent late gadolinium enhancement (LGE) CMR and 12-lead electrocardiogram. The distribution and magnitude of LV segmental hypertrophy and LGE were assessed according to the AHA 17-segment model and analyzed in relation to T-wave inversions. RESULTS: Of 196 HCM patients, 144 (73%) exhibited T-wave inversions. 144 (73%) patients had evidence of myocardial fibrosis as defined by LGE, and the prevalence of LGE was significantly higher in patients with T-wave inversions compared with those without T-wave inversions (78% vs. 59%, P=0.008). T-wave inversions were related to basal anterior and basal anteroseptal LGE (20% vs. 10%, P=0.04 and 68% vs. 46%, P=0.005, respectively). In addition, T-wave inversions were associated with greater basal anteroseptal and basal inferior wall thickness (19.5 ± 4.7 mm vs. 16.7 ± 4.5mm, P<0.001 and 10.9 ± 3.3mm vs. 9.6 ± 3.0mm, P=0.01, respectively). By logistic regression analysis, basal anteroseptal wall thickness and LGE were independent determinants of T-wave inversions (P=0.005, P=0.01, respectively). CONCLUSIONS: T-wave inversions in HCM are associated with LGE and wall thickness of the left ventricular basal segments. Moreover, basal anteroseptal wall thickness and LGE are independent determinants of T-wave inversions.
OBJECTIVES: To investigate the relationship between T-wave inversions and left ventricular (LV) segmental hypertrophy and myocardial fibrosis assessed by cardiovascular magnetic resonance (CMR) in patients with non-apical hypertrophic cardiomyopathy (HCM). METHODS: 196 consecutive patients with non-apical HCM underwent late gadolinium enhancement (LGE) CMR and 12-lead electrocardiogram. The distribution and magnitude of LV segmental hypertrophy and LGE were assessed according to the AHA 17-segment model and analyzed in relation to T-wave inversions. RESULTS: Of 196 HCM patients, 144 (73%) exhibited T-wave inversions. 144 (73%) patients had evidence of myocardial fibrosis as defined by LGE, and the prevalence of LGE was significantly higher in patients with T-wave inversions compared with those without T-wave inversions (78% vs. 59%, P=0.008). T-wave inversions were related to basal anterior and basal anteroseptal LGE (20% vs. 10%, P=0.04 and 68% vs. 46%, P=0.005, respectively). In addition, T-wave inversions were associated with greater basal anteroseptal and basal inferior wall thickness (19.5 ± 4.7 mm vs. 16.7 ± 4.5mm, P<0.001 and 10.9 ± 3.3mm vs. 9.6 ± 3.0mm, P=0.01, respectively). By logistic regression analysis, basal anteroseptal wall thickness and LGE were independent determinants of T-wave inversions (P=0.005, P=0.01, respectively). CONCLUSIONS: T-wave inversions in HCM are associated with LGE and wall thickness of the left ventricular basal segments. Moreover, basal anteroseptal wall thickness and LGE are independent determinants of T-wave inversions.
Authors: Gabriela Miana de Mattos Paixão; Horácio Eduardo Veronesi; Halsted Alarcão Gomes Pereira da Silva; José Nunes de Alencar Neto; Carolina de Paulo Maldi; Luciano de Figueiredo Aguiar Filho; Ibrahim Masciarelli Francisco Pinto; Francisco Faustino de Albuquerque Carneiro de França; Edileide de Barros Correia Journal: Arq Bras Cardiol Date: 2018-01 Impact factor: 2.000