Evolution of the electrocardiographic changes in patients with hypertrophic cardiomyopathy.
In 75 patients with hypertrophic cardiomopathy (HCM) followed for a mean period of 5.5 years (range 2-20 years), evolution of the electrocardiographic (EKG) changes was assessed. Progression of EKG abnormalities occurred in 35 patients (47%). It was manifested by an increase in precordial QRS voltage in 33 patients, development of new P-wave mitral in 11 patients, and development or disappearance of pathologic Q waves in 14 patients. With follow-up times greater than 5 years, 5-8 years, and greater than 8 years, EKG progression was present in 27, 41, and 80% of patients, respectively. Age less than 30 years at the beginning of study and left ventricular outflow obstruction predisposed to EKG progression within 5-8 years. Patients with progressive EKG changes were more prone to experience clinical deterioration than those without EKG progression (63 vs. 15%, p less than 0.001). With chronic verapamil administration, progression of EKG abnormalities occurred insignificantly less often than with propranolol treatment (35 vs. 64%, p = 0.20). It is concluded that with long-term follow-up, HCM tends to progress in a significant proportion of adult patients.
Tendera
M
M
2nd Department of Cardiology, Silesian Medical Academy, Zabrze, Poland.
Poloński
L
L
Wodniecki
J
J
Kardaszewicz
P
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D015984:Causality; D002648:Child; D004452:Echocardiography; D004562:Electrocardiography / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011433:Propranolol / Q000627:therapeutic use; D014694:Ventricular Outflow Obstruction / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D014700:Verapamil / Q000627:therapeutic use
D011433:Propranolol; D014700:Verapamil