Early Repolarization Pattern and Left Ventricular Mass in Hypertrophic Cardiomyopathy

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.