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European Heart Journal Advance Access published online on June 14, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl101
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received December 23, 2005
Revised May 17, 2006
Accepted May 30, 2006

Clinical research

Interpretation of electrocardiographic abnormalities in hypertrophic cardiomyopathy with cardiac magnetic resonance

Carlos A. Dumont 1, Lorenzo Monserrat 1 *, Rafaela Soler 2, Esther Rodríguez 2, Xusto Fernandez 1, Jesús Peteiro 1, Alberto Bouzas 1, Beatriz Bouzas 1, and Alfonso Castro-Beiras 1

1 Department of Cardiology, Juan Canalejo Hospital, Xubias de Arriba 84, 15006 La Coruña, Spain
2 Department of Radiology, Juan Canalejo Hospital, La Coruña, Spain

* To whom correspondence should be addressed.
Lorenzo Monserrat, E-mail: lorenzo_monserrat{at}canalejo.org


  Abstract

Aims 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.

Methods and 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).

Conclusion 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.

Keywords: Hypertrophy; Cardiomyopathy; Electrocardiography; Magnetic resonance imaging.
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Redefining cardiomyopathies: the role of cardiovascular magnetic resonance imaging: reply
Eur. Heart J., December 2, 2007; 28(24): 3095 - 3095.
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