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Gender-specific clinical characteristics of deep Q waves in hypertrophic cardiomyopathy
Yuki Ohmoto-Sekine1, Jun-ichi Suzuki, Ryoichi Shimamoto
1Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Insights
Deep Q waves are more common in women with hypertrophic cardiomyopathy (HCM) than in men. However, the underlying cardiac morphology and electrocardiographic patterns in HCM with deep Q waves are similar across genders.
Area of Science:
- Cardiology
- Genetics
- Medical Imaging
Background:
- Hypertrophic cardiomyopathy (HCM) predominantly affects males, but deep Q waves may be more prevalent in female patients.
- Previous observations suggest a potential underdiagnosis of deep Q waves in women with HCM.
Purpose of the Study:
- To investigate gender-based differences in the prevalence of deep Q waves in hypertrophic cardiomyopathy.
- To analyze the morphologic and electrocardiographic characteristics of HCM patients with deep Q waves, comparing males and females.
Main Methods:
- Cardiac magnetic resonance (CMR) imaging was used to assess 200 patients with HCM for deep Q waves in limb leads.
- The study correlated deep Q wave distribution with left ventricular (LV) hypertrophy patterns using contiguous LV short-axis images.
Main Results:
- Deep Q waves were found in 28.6% of female HCM patients versus 5.8% of male patients (P<0.001).
- In patients with deep Q waves, maximum LV hypertrophy was localized to the basal anterior wall or midventricular septum in both sexes.
- Q wave patterns consistently indicated hypertrophy location, with similar distributions observed between genders.
Conclusions:
- Deep Q waves are significantly more prevalent in female patients diagnosed with hypertrophic cardiomyopathy.
- Despite higher prevalence in women, the electrocardiographic and morphologic features of deep Q waves in HCM are comparable between sexes.
Background:
Despite male predominance in the prevalence of hypertrophic cardiomyopathy (HCM), repeated diagnosis at our institute indicates a possible higher prevalence of deep Q waves with HCM in women.
Objective:
The current study examined gender similarities and differences in the prevalence of deep Q waves in HCM and in the morphologic and electrocardiographic features of HCM with deep Q waves.
Methods:
Patients with HCM underwent cardiac magnetic resonance (CMR) imaging to identify the prevalence of deep Q waves in electrocardiographic limb leads, and to analyze the relationship between distribution patterns of deep Q waves and those of the localization of maximum amplitude of left ventricular (LV) hypertrophy. Contiguous LV short-axis images were obtained from the base toward the apex.
Results:
Of the 200 consecutive patients (172 males, aged 20-78 years; 28 females, aged 16-79 years) with HCM who underwent CMR imaging, 10 male and 8 female patients had deep Q waves. Deep Q waves were more prevalent in females with HCM than in their male counterparts (28.6% vs 5.8%, respectively; P<0.001). Of the 18 patients with deep Q waves, maximum wall thickness was localized at either the basal anterior wall or the midventricular septum in 9 (90%) of the 10 male patients and 6 (75%) of the 8 female patients. In both sexes, the Q wave distribution pattern of I and aVL and of II and aVF indicated localization of maximum hypertrophy at the midventricular septum in 6 (75%) of the 8 patients with the former pattern, and at the basal anterior wall in 9 (90%) of the 10 patients with the latter pattern.
Conclusions:
Diagnostic deep Q waves were detected more frequently in female patients with HCM than in their male counterparts. In HCM with deep Q waves in limb leads, morphologic and electrocardiographic analysis showed similar features in both sexes.
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