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Diastolic dysfunction grading, echocardiographic and electrocardiogram findings in 50 patients with apical

R Aslannif1, K Suraya2, H B Koh2

  • 1National Heart Institute, Cardiology Department, Kuala Lumpur, Malaysia. dr.aslannif@ijn.com.my.

The Medical Journal of Malaysia
|January 14, 2020
PubMed

Insights

Apical hypertrophic cardiomyopathy (Apical HCM) is more common in Asia. This study analyzed diastolic function, echocardiography, and ECGs in 50 Apical HCM patients, finding deep T-wave inversion on ECGs and characteristic LV appearance are key diagnostic indicators.

Area of Science:

  • Cardiology
  • Echocardiography
  • Electrocardiography

Background:

  • Apical hypertrophic cardiomyopathy (Apical HCM) is an uncommon variant of hypertrophic cardiomyopathy, more prevalent in Asian populations.
  • Understanding its specific echocardiographic and electrocardiographic features is crucial for diagnosis and management.

Purpose of the Study:

  • To analyze diastolic dysfunction grading, echocardiographic parameters, and electrocardiogram (ECG) findings in patients with Apical HCM.
  • To evaluate the utility of the 2016 American Society of Echocardiography (ASE) diastolic guidelines in assessing Apical HCM patients.

Main Methods:

  • Retrospective, single-center study of 50 patients diagnosed with Apical HCM.
  • Assessment of echocardiography images for diastolic function grading and left ventricle (LV) morphology.
  • Review of presenting electrocardiograms (ECGs) for specific criteria.

Main Results:

  • Diastolic function was assessable in 74% of patients using 2016 ASE guidelines.
  • Characteristic 'ace-of-spades' LV appearance was noted in 50% of patients.
  • All patients exhibited T-wave inversion in anterior ECG leads; 52% met ECG criteria for left ventricular hypertrophy (LVH).

Conclusions:

  • The 2016 ASE guidelines facilitate LV diastolic function evaluation in Apical HCM.
  • Deep T-wave inversion on ECG combined with an 'ace-of-spades' LV appearance should raise clinical suspicion for Apical HCM.
Abstract

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