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Identifying Obstructive Hypertrophic Cardiomyopathy from Nonobstructive Hypertrophic Cardiomyopathy: Development and

Lanyan Guo1, Zhiling Ma1, Weiping Yang1

  • 1Department of Cardiology, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China.

Global Heart
|August 7, 2023
PubMed

Insights

A new electrocardiogram (ECG) model using P wave interval and SV1 can differentiate obstructive hypertrophic cardiomyopathy (HOCM) from nonobstructive hypertrophic cardiomyopathy (HNCM). This tool aids in initial HCM patient classification.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Biomedical Engineering

Background:

  • Hypertrophic cardiomyopathy (HCM) presents heterogeneously in obstructive (HOCM) and nonobstructive (HNCM) forms.
  • Electrocardiography (ECG) is a common screening tool, but its utility for initial HOCM/HNCM classification is unclear.

Purpose of the Study:

  • To develop a pragmatic model using standard 12-lead ECG features for initial HOCM/HNCM identification.
  • To assess the model's diagnostic performance, calibration, and clinical utility.

Main Methods:

  • Prospective data from 172 HCM patients for training and 62 for temporal validation.
  • External validation using 889 retrospectively collected ECG samples (390 HOCM, 499 HNCM).
  • Multivariable logistic regression to build the prediction model.

Main Results:

  • Ten ECG parameters differed significantly between HOCM and HNCM (P < 0.05).
  • A model using P wave interval and SV1 achieved a C-statistic of 0.805 (temporal) and 0.776 (external) for HOCM/HNCM differentiation.
  • Model demonstrated good calibration and clinical utility.

Conclusions:

  • The P wave interval and SV1 model effectively discriminates HOCM from HNCM.
  • This pragmatic ECG-based model can assist in the initial classification of HCM patients.
Abstract

Keywords:
classificationelectrocardiogramhypertrophic cardiomyopathynonobstructive hypertrophic cardiomyopathyobstructive hypertrophic cardiomyopathy

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