title: Interpretation of electrocardiographic abnormalities in hypertrophic cardiomyopathy with cardiac magnetic resonance.
abstract: OBJECTIVE
  To clarify the mechanisms of electrocardiographic abnormalities in hypertrophic cardiomyopathy, 102 patients were examined with cardiac magnetic resonance. Distribution and magnitude of hypertrophy and late-enhancement were correlated with electrocardiographic abnormalities.
  
  
  RESULTS
  Abnormal Q waves were associated with greater upper anterior septal thickness (22+/-7 mm vs. 18+/-5 mm, P=0.001) and increased ratios of upper anterior septum to mean inferolateral (P=0.01), anterolateral (P=0.002), apical (P=0.001), and right ventricular (P=0.001) wall thickness. There was no relation between abnormal Q waves and late-enhancement, except for Q waves >/=40 ms (P=0.02). Conduction disturbances and absent septal Q waves were associated with late-enhancement (89 vs. 45%, P=0.01 and 75 vs. 39%, P=0.002, respectively). The depth of negative T waves was related to an increased ratio of the mean thickness between apical and basal level (P=0.01), and to the presence of apical late-enhancement (P=0.03).
  
  
  CONCLUSIONS
  Abnormal Q waves reflect the interrelation between upper anterior septal thickness and other regions of the left and right ventricles, and wider Q waves are associated with late-enhancement. Conduction disturbances and absent septal Q waves are associated with late-enhancement. The depth of negative T waves is related to craniocaudal asymmetry and apical late-enhancement.
authors.affiliation: Department of Cardiology, Juan Canalejo Hospital, Xubias de Arriba 84, 15006 La Coruña, Spain.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Dumont
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monserrat
authors.forename: Rafaela
authors.initials: R
authors.lastname: Soler
authors.forename: Esther
authors.initials: E
authors.lastname: Rodríguez
authors.forename: Xusto
authors.initials: X
authors.lastname: Fernandez
authors.forename: Jesús
authors.initials: J
authors.lastname: Peteiro
authors.forename: Alberto
authors.initials: A
authors.lastname: Bouzas
authors.forename: Beatriz
authors.initials: B
authors.lastname: Bouzas
authors.forename: Alfonso
authors.initials: A
authors.lastname: Castro-Beiras
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis; D017380:Hypertrophy, Right Ventricular / Q000175:diagnosis; D018810:Magnetic Resonance Angiography / Q000592:standards; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity