[A study on the pattern of myocardial distribution and its relationship to the genesis of giant negative T wave in patients with hypertrophic cardiomyopathy].
Quantitative measurements of cardiac mass were performed in patients (pts) with hypertrophic cardiomyopathy (HCM) to assess the relationship between the pattern of myocardial distribution and the degree of T wave inversion on the electrocardiogram. Thirty-three pts with HCM (10: apical hypertrophy, 18: non-obstructive, 5: obstructive) and 10 age-matched normal subjects were studied. Electrocardiographically triggered X-ray computed tomographic scannings were obtained from apex to base of the left ventricle. Left ventricular apex/septum wall thickness ratio (Ta/Ts), left ventricular apex/base mass ratio (Ma/Mb) and total left ventricular mass (LVM) were measured at end-diastole. In 61% of the pts the electrocardiogram showed giant negative T wave (GNT: defined as greater than 1mV). All pts with apical hypertrophy had GNT, however GNT was observed only in 44% of non-obstructive and in 40% of obstructive pts. Both Ta/Ts and Ma/Mb were significantly greater in pts with GNT than those without GNT (1.34 +/- 0.40 vs 0.66 +/- 0.21, p less than 0.001, 1.65 +/- 0.28 vs 1.28 +/- 0.17, p less than 0.001) and normal controls (1.34 +/- 0.40 vs 0.99 +/- 0.17, p less than 0.01, 1.65 +/- 0.28 vs 1.28 +/- 0.11, p less than 0.001), while LVM was significantly increased in pts without GNT than those with GNT (191.4 +/- 57.0 vs 139.4 +/- 39. 2, p less than 0.01) and normal controls (191.4 +/- 57.0 vs 97.2 +/- 13.9, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Anzai
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Department of Cardiovascular Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
D000200:Action Potentials; D002311:Cardiomyopathy, Dilated / Q000473:pathology / Q000503:physiopathology; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D014057:Tomography, X-Ray Computed