Ozcan Ozeke1, Cagatay Ertan2, Gokhan Keskin2, Bulent Deveci3, Serkan Cay4, Fırat Ozcan4, Serkan Topaloglu4, Dursun Aras4, Ahmet Duran Demir2, Sinan Aydogdu4. 1. Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: ozcanozeke@gmail.com. 2. Acibadem University, Department of Cardiology, Eskisehir, Turkey. 3. Medicana Hospital, Department of Cardiology, Ankara, Turkey. 4. Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
Abstract
OBJECTIVES: Apical aneurysms in patients with hypertrophic cardiomyopathy (HCM) represent an underrecognized but clinically important subset of HCM patients. However it may be frequently missed by echocardiography because of poor image quality of left ventricular apex. We aimed to compare electrocardiographic STE in HCM patients with and without apical aneurysm. METHODS: We developed this clinical review using an extensive MEDLINE review of the literature and data from our laboratories; and some electrocardiographic parameters including STE were analysed in HCM patients with and without apical aneurysm. RESULTS: There were 29 HCM patients without apical aneurysm (Group 1; 52.6±17.7years, 69% male) and 28 HCM patients with apical aneurysm (Group 2; 59.6±13.2years, 57% male). The STE in V4-6 derivations were statistically more frequent in patients with apical aneurysm compared to those without aneurysm (93% vs 7%, p<0.001). There was a positive correlation between the presence of the STE in V4-6 derivations and the presence of the apical aneurysm (Spearman's ρ=0.895, p<0.001). CONCLUSIONS: Clinicians and specifically echocardiographers must pay special attention on the electrocardiography to correctly detect the frequently overlooked apical aneurysm in HCM patients, and should be careful for apical aneurysm particularly in the presence of STE in V4-6 derivations.
OBJECTIVES: Apical aneurysms in patients with hypertrophic cardiomyopathy (HCM) represent an underrecognized but clinically important subset of HCM patients. However it may be frequently missed by echocardiography because of poor image quality of left ventricular apex. We aimed to compare electrocardiographic STE in HCM patients with and without apical aneurysm. METHODS: We developed this clinical review using an extensive MEDLINE review of the literature and data from our laboratories; and some electrocardiographic parameters including STE were analysed in HCM patients with and without apical aneurysm. RESULTS: There were 29 HCM patients without apical aneurysm (Group 1; 52.6±17.7years, 69% male) and 28 HCM patients with apical aneurysm (Group 2; 59.6±13.2years, 57% male). The STE in V4-6 derivations were statistically more frequent in patients with apical aneurysm compared to those without aneurysm (93% vs 7%, p<0.001). There was a positive correlation between the presence of the STE in V4-6 derivations and the presence of the apical aneurysm (Spearman's ρ=0.895, p<0.001). CONCLUSIONS: Clinicians and specifically echocardiographers must pay special attention on the electrocardiography to correctly detect the frequently overlooked apical aneurysm in HCM patients, and should be careful for apical aneurysm particularly in the presence of STE in V4-6 derivations.
Authors: Josepha Binder; Christine H Attenhofer Jost; Kyle W Klarich; Heidi M Connolly; A Jamil Tajik; Christopher G Scott; Paul R Julsrud; Jo-Ellen Ehrsam; Kent R Bailey; Steve R Ommen Journal: J Am Soc Echocardiogr Date: 2011-04-20 Impact factor: 5.251