title: Electrocardiographic evolution in patients with hypertrophic cardiomyopathy who develop a left ventricular apical aneurysm.
abstract: BACKGROUND
  Hypertrophic cardiomyopathy (HCM) patients with apical aneurysm have a largely unfavourable clinical course, and are often unrecognised because echocardiography is limited in the assessment of the left ventricular (LV) apex. The aim of this study is the identification of electrocardiographic (ECG) abnormalities associated with the development of apical aneurysm in HCM patients.
  
  
  METHODS
  Electrocardiographic features were assessed in 14 HCM patients who had a good-quality baseline ECG recorded before and after the diagnosis of apical aneurysm.
  
  
  RESULTS
  During follow-up (8.8±7.5years), the following ECG changes were observed: increase in QRS-complex duration (87±12ms to 118±34ms, p=0.006), QRS-complex fragmentation, decrease in QRS-complex amplitude (SV1+RV5-6, from 41±18mm to 26±11mm, p=0.015), ST-segment elevation in V4-V6 (J-point in V5, from -0.9±1.3mm to +0.7±1.3, p=0.003), positivisation of negative T waves in V3-V6 (T-wave depth in V5, from -3.4±6.6 to +3.1±4.1, p=0.005).
  
  
  CONCLUSIONS
  HCM patients who develop LV apical aneurysm exhibit distinctive ECG changes along with apical remodelling. Suggestive ECGs should lead the physician to study LV apex by nonstandard echocardiographic views, and perform MRI.
authors.affiliation: Dipartimento di Medicina Clinica e Molecolare, Università Sapienza, Rome, Italy.
authors.forename: Ermelinda
authors.initials: E
authors.lastname: Pennacchini
authors.affiliation: Dipartimento di Medicina Clinica e Molecolare, Università Sapienza, Rome, Italy.
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Musumeci
authors.affiliation: Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Conte
authors.affiliation: Krankenanstalt Rudolfstiftung, Vienna, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Stöllberger
authors.affiliation: Ente Ospedaliero Ospedali Galliera, Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Formisano
authors.affiliation: Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bongioanni
authors.affiliation: Dipartimento di Medicina Clinica e Molecolare, Università Sapienza, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Francia
authors.affiliation: Dipartimento di Medicina Clinica e Molecolare, Università Sapienza, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.affiliation: Dipartimento di Medicina Clinica e Molecolare, Università Sapienza, Rome, Italy. Electronic address: camillo.autore@uniroma1.it.
authors.forename: Camillo
authors.initials: C
authors.lastname: Autore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis*; D018450:Disease Progression; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology*
keywords: Apical aneurysm; Electrocardiography; Hypertrophic cardiomyopathy