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Electrocardiographic evolution in patients with hypertrophic cardiomyopathy who develop a left ventricular apical

Ermelinda Pennacchini1, Maria Beatrice Musumeci1, Maria Rosa Conte2

  • 1Dipartimento di Medicina Clinica e Molecolare, Università Sapienza, Rome, Italy.

Journal of Electrocardiology
|June 28, 2015
PubMed

Insights

Electrocardiogram (ECG) changes, including QRS widening and ST-segment elevation, can help identify apical aneurysms in hypertrophic cardiomyopathy (HCM) patients. These ECG findings prompt further investigation of the left ventricular apex.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrocardiography

Background:

  • Hypertrophic cardiomyopathy (HCM) with apical aneurysm presents a poor prognosis.
  • Echocardiography has limitations in assessing the left ventricular (LV) apex in HCM.
  • Early identification of apical aneurysms is crucial for patient management.

Purpose of the Study:

  • To identify specific electrocardiographic (ECG) abnormalities associated with the development of apical aneurysms in HCM patients.
  • To correlate ECG findings with apical remodelling in HCM.

Main Methods:

  • Retrospective analysis of ECGs from 14 HCM patients.
  • ECGs were recorded before and after the diagnosis of apical aneurysm.
  • Longitudinal follow-up of 8.8±7.5 years.

Main Results:

  • Significant increase in QRS-complex duration (87±12ms to 118±34ms).
  • Observed QRS-complex fragmentation and decreased QRS amplitude.
  • ST-segment elevation in V4-V6 and T-wave normalization in V3-V6 were noted.

Conclusions:

  • Distinctive ECG changes accompany LV apical aneurysm development in HCM.
  • Suggestive ECG patterns warrant further investigation of the LV apex using advanced echocardiography and MRI.
Abstract

Keywords:
Apical aneurysmElectrocardiographyHypertrophic cardiomyopathy

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