title: CMR assessment of the left ventricle apical morphology in subjects with unexplainable giant T-wave inversion and without apical wall thickness ≥15 mm.
abstract: OBJECTIVE
  Patients with unexplainable giant T-wave inversion in the precordial leads and apical wall thickness <15 mm have been reported. These patients cannot be diagnosed as apical hypertrophic cardiomyopathy (AHCM) according to the current criteria. The objective of this study was to evaluate the apical morphological features of this type of patients using cardiac magnetic resonance.
  
  
  RESULTS
  Institutional ethics approval and written informed consent were obtained. A total of 60 subjects with unexplainable giant T-wave inversion and 76 healthy volunteers were prospectively enrolled in the study. The segmented left ventricular (LV) wall thickness was measured according to the American Heart Association 17-segmented model. The apical angle (apA) as well as the regional variations in LV wall thickness was analysed. Considerable variation in LV wall thickness in normals was observed with progressive thinning from the base to apex (male and female, P < 0.01). The apical thickness of subjects with giant T-wave inversion was 8.10 ± 1.67 mm in male, which is thicker than that of controls (4.14 ± 1.17 mm, P < 0.01). In female, the apical thickness was also significantly different from controls (5.85 ± 2.16 vs. 2.99 ± 0.65 mm, P < 0.01). Compared with normals, the apA decreased significantly in male (87.44 ± 13.86 vs.115.03 ± 9.90°, P < 0.01) and female (90.69 ± 8.84 vs. 110.07 ± 13.58°, P < 0.01) subjects, respectively.
  
  
  CONCLUSIONS
  Although the absolute thickness of apical wall was below the current diagnostic criteria of AHCM, the apical morphological features of subjects with unexplainable giant T-wave inversion were significantly different from normals. Whether these subjects should be included into a preclinical scope of AHCM needs further investigations.
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.|Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Bailin
authors.initials: B
authors.lastname: Wu
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China coolkan@163.com cjr_zhaoshihua@163.com.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Minjie
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: The Public Health College of Hebei Medical University, Shijiazhuang, Hebei, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Song
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ling
authors.affiliation: The Heart-Lung Testing Center, Fuwai Hospital, Beijing, China.
authors.forename: Jinghan
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Yin
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Lan
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Dai
authors.affiliation: Department of Cardiology, Fuwai Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Echocardiography, Fuwai Hospital, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Echocardiography, Fuwai Hospital, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Fuwai Hospital, Beijing, China.
authors.forename: Zuoxiang
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Radiology, Biomedical Engineering and Medical Science, Kyungpook National University, School of Medicine Daegu, Daegu, South Korea.
authors.forename: Jongmin
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Hwan Seok
authors.initials: HS
authors.lastname: Yong
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Mehul B
authors.initials: MB
authors.lastname: Patel
authors.affiliation: Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, Beijing, China coolkan@163.com cjr_zhaoshihua@163.com.|State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China.|Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Shihua
authors.initials: S
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D053840:Brugada Syndrome / Q000000981:diagnostic imaging*; D000075224:Cardiac Conduction System Disease; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
keywords: apical hypertrophic cardiomyopathy; cardiovascular MRI; giant negative T-wave; wall thickness