Document Detail

Correlation of electrocardiographic changes and myocardial fibrosis in patients with hypertrophic cardiomyopathy detected by cardiac magnetic resonance imaging.
MedLine Citation:
PMID:  23070984     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite several electrophysiologic and pathologic studies, the cause of electrocardiographic (ECG) changes in patients with hypertrophic cardiomyopathy (HCM) remains unclear. Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging can detect myocardial fibrosis. We aimed to assess the relationship between ECG findings and LGE in such patients.
HYPOTHESIS: Myocardial LGE may be associated with ECG changes in HCM.
METHODS: Seventy consecutive patients with HCM (mean age, 55.5 ± 10.7 years; 47 males) underwent CMR and 12-lead ECG. The subjects were divided into 3 groups according to the type of hypertrophy: the asymmetric septal hypertrophy group (ASH group, n = 31), the apical hypertrophy group (AP group, n = 22), and concentric hypertrophy group (CH group, n = 17). The transmural and segmental extent, pattern, and location of myocardial LGE were assessed and analyzed in relation to ECG changes.
RESULTS: All of the subjects showed some degree of LGE on CMR. The AP group showed significantly higher prevalence of negative T-wave (P = 0.028) and deep negative T-wave inversion (P = 0.001) than the ASH and CH groups. The total volume of LGE did not show any significant association with ECG changes. LGE detected at the interventricular septum was associated with increased QRS duration (P = 0.009) and was found in 94% of the ASH group, 59% of the AP group, and 77% of the CH group. LGE at the apex of the heart was present in 32% of the ASH group, 73% of the AP group, and 35% of the CH group and was also associated with negative T-wave (P = 0.006) and deep negative T-wave inversion (P = 0.018). Multifocal LGE lesions were associated with increased QRS duration (P = 0.039) as opposed to single nodular or patchy pattern of presence.
CONCLUSIONS: The location of myocardial LGE in HCM shows significant association with various ECG changes. This may be useful information for initially evaluating subjects with HCM and adds pathophysiological insight into understanding ECG changes in myocardial diseases that cannot be explained otherwise.
Bong Gun Song; Hyun Suk Yang; Hweung Kon Hwang; Gu Hyun Kang; Yong Hwan Park; Woo Jung Chun; Ju Hyeon Oh
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Retracted Publication     Date:  2012-10-15
Journal Detail:
Title:  Clinical cardiology     Volume:  36     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-14     Completed Date:  2013-06-25     Revised Date:  2014-04-21    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-5     Citation Subset:  IM    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
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MeSH Terms
Cardiomyopathies / complications,  diagnosis*
Cardiomyopathy, Hypertrophic / complications*,  diagnosis
Contrast Media / diagnostic use
Diagnosis, Differential
Fibrosis / complications,  diagnosis
Gadolinium DTPA / diagnostic use
Magnetic Resonance Imaging, Cine / methods*
Middle Aged
Myocardium / pathology*
Reproducibility of Results
Reg. No./Substance:
0/Contrast Media; K2I13DR72L/Gadolinium DTPA
Retraction In:
Clin Cardiol. 2013 Nov;36(11):711   [PMID:  24730058 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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