title: T-wave inversions related to left ventricular basal hypertrophy and myocardial fibrosis in non-apical hypertrophic cardiomyopathy: a cardiovascular magnetic resonance imaging study.
abstract: OBJECTIVE
  To investigate the relationship between T-wave inversions and left ventricular (LV) segmental hypertrophy and myocardial fibrosis assessed by cardiovascular magnetic resonance (CMR) in patients with non-apical hypertrophic cardiomyopathy (HCM).
  
  
  METHODS
  196 consecutive patients with non-apical HCM underwent late gadolinium enhancement (LGE) CMR and 12-lead electrocardiogram. The distribution and magnitude of LV segmental hypertrophy and LGE were assessed according to the AHA 17-segment model and analyzed in relation to T-wave inversions.
  
  
  RESULTS
  Of 196 HCM patients, 144 (73%) exhibited T-wave inversions. 144 (73%) patients had evidence of myocardial ﬁbrosis as defined by LGE, and the prevalence of LGE was significantly higher in patients with T-wave inversions compared with those without T-wave inversions (78% vs. 59%, P=0.008). T-wave inversions were related to basal anterior and basal anteroseptal LGE (20% vs. 10%, P=0.04 and 68% vs. 46%, P=0.005, respectively). In addition, T-wave inversions were associated with greater basal anteroseptal and basal inferior wall thickness (19.5 ± 4.7 mm vs. 16.7 ± 4.5mm, P<0.001 and 10.9 ± 3.3mm vs. 9.6 ± 3.0mm, P=0.01, respectively). By logistic regression analysis, basal anteroseptal wall thickness and LGE were independent determinants of T-wave inversions (P=0.005, P=0.01, respectively).
  
  
  CONCLUSIONS
  T-wave inversions in HCM are associated with LGE and wall thickness of the left ventricular basal segments. Moreover, basal anteroseptal wall thickness and LGE are independent determinants of T-wave inversions.
authors: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: cxy0202@126.com.
authors: Xiuyu
authors: X
authors: Chen
authors: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: zhaoshihua0202@126.com.
authors: Shihua
authors: S
authors: Zhao
authors: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: taozhao0202@126.com.
authors: Tao
authors: T
authors: Zhao
authors: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: lmjkan@126.com.
authors: Minjie
authors: M
authors: Lu
authors: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: gangyin0202@126.com.
authors: Gang
authors: G
authors: Yin
authors: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: jiangsl-2011@163.com.
authors: Shiliang
authors: S
authors: Jiang
authors: NIHR Biomedical Research Unit, Royal Brompton Hospital Sydney Street, London, SW3 6NP, United Kingdom. Electronic address: s.prasad@rbht.nhs.uk.
authors: Sanjay
authors: S
authors: Prasad
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D005355:Fibrosis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
keywords: Cardiovascular magnetic resonance; Electrocardiography; Hypertrophic cardiomyopathy; Late gadolinium enhancement