title: Phenotypic spectrum and clinical characteristics of apical hypertrophic cardiomyopathy: multicenter echo-Doppler study.
abstract: OBJECTIVE
  The aim of this study was to define the phenotypic spectrum of apical hypertrophic cardiomyopathy (ApHCM) and clinical characteristics pertaining to identified subtypes.
  
  
  METHODS
  In 182 consecutive ApHCM patients (58.9 +/- 11.2 years; 142 men) with left ventricular ejection fraction > or =50%, we measured end-diastolic wall thickness of all 16 left ventricular segments to determine patterns of hypertrophy. Echo-Doppler parameters, electrocardiography patterns, and clinical findings were analyzed.
  
  
  RESULTS
  ApHCM was classified into three types as pure focal (n = 81), pure diffuse (n = 70) and mixed type (n = 31) according to patterns of hypertrophy. Incidence of atrial fibrillation (5% for pure focal vs. 11% for pure diffuse vs. 23% for mixed type, p < 0.05) and left atrial volume index (30.9 +/- 11.8, 35.7 +/- 14.8, and 41.3 +/- 15.9 ml/m(2), respectively, p < 0.001) were significantly different among subtypes. Peak systolic (6.6 +/- 1.0 vs. 6.3 +/- 1.2 vs. 5.9 +/- 1.1 cm/s, respectively, p < 0.05), diastolic (5.1 +/- 1.8 vs. 5.0 +/- 1.2 vs. 4.1 +/- 1.3 cm/s, respectively, p < 0.05) mitral annular velocity, E/E' (13.3 +/- 4.2 vs. 13.7 +/- 5.4 vs. 16.1 +/- 6.1, respectively, p < 0.05) were also significantly different.
  
  
  CONCLUSIONS
  ApHCM contains three morphologically distinct phenotypes and detailed subtyping is important in the prediction of development of atrial fibrillation, left atrial volume index and left ventricular longitudinal function.
authors.affiliation: Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Duk-Hyun
authors.initials: DH
authors.lastname: Kang
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Song
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000503:physiopathology; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013318:Stroke Volume