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Early Repolarization Pattern and Left Ventricular Mass in Hypertrophic Cardiomyopathy

Pedro Miguel Oliveira Azevedo1,2, Cláudio Guerreiro3, Ricardo Ladeiras-Lopes3

  • 1Cardiology Department, Centro Hospitalar e Universitário do Algarve, Faro, Portugal, pmazevedo@chalgarve.min-saude.pt.

Cardiology
|February 5, 2020
PubMed

Insights

Early repolarization pattern (ERP) is linked to increased left ventricular mass (LVM) in hypertrophic cardiomyopathy (HCM) patients. This may help explain the higher sudden cardiac death (SCD) risk associated with J waves in HCM.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Imaging

Background:

  • J-point elevation in inferior/lateral leads correlates with sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM).
  • Severe left ventricular hypertrophy (LVH) and late gadolinium enhancement (LGE) are known risk factors for SCD in HCM.
  • The precise mechanism linking J-point elevation to SCD in HCM remains unclear.

Purpose of the Study:

  • To investigate the association between early repolarization pattern (ERP) and left ventricular mass (LVM).
  • To assess the relationship between ERP and LGE extent in HCM patients.
  • To explore potential mechanisms linking ERP to increased SCD risk in HCM.

Main Methods:

  • Retrospective cohort study of 85 HCM patients.
  • Cardiac magnetic resonance (CMR) and electrocardiogram (ECG) data were analyzed.
  • Patients were categorized based on the presence or absence of ERP, excluding those with confounding ECG findings.

Main Results:

  • ERP was identified in 10.6% of the HCM cohort.
  • Patients with ERP exhibited significantly greater indexed LVM compared to those without (112.5 vs. 87.8 g/m², p=0.006).
  • A 4.2-fold increased odds of ERP were observed per standard deviation increase in indexed LVM (p=0.005).
  • No significant difference in LGE extent was found between groups.

Conclusions:

  • ERP is associated with greater LVM in HCM patients, as assessed by CMR.
  • This association may partially elucidate the link between J waves and elevated SCD risk in HCM.
  • Further research is warranted to confirm ERP's role as a potential SCD risk marker in HCM.
Abstract

Keywords:
Early repolarizationElectrocardiogramHypertrophic cardiomyopathyLeft ventricular massMagnetic resonance imaging

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