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Asymmetric apical hypertrophy: ten years experience
Insights
Asymmetric apical hypertrophy, a form of hypertrophic cardiomyopathy, primarily affects men over 40. Diagnosis relies on echocardiography, with a good prognosis and infrequent complications observed over 10 years.
Area of Science:
- Cardiology
- Cardiovascular Diseases
Background:
- Asymmetric apical hypertrophy (AAH) is a distinct form of hypertrophic cardiomyopathy (HCM).
- It is characterized by exclusive left ventricular apex involvement and giant T wave inversion in precordial leads.
- AAH is predominantly observed in men over 40 years of age, often with a negative family history and minimal symptoms.
Purpose of the Study:
- To report on 10 years of clinical experience with 31 patients diagnosed with asymmetric apical hypertrophy.
- To describe the clinical characteristics, diagnostic methods, and prognosis of AAH.
- To investigate the relationship between AAH and other forms of hypertrophic cardiomyopathy.
Main Methods:
- Retrospective analysis of 31 patients with AAH over a 10-year period.
- Clinical examination, electrocardiography (ECG), echocardiography (including 2D), and left ventriculography were utilized for diagnosis and assessment.
- Patient data including demographics, symptoms, physical findings, ECG changes, and diagnostic imaging results were reviewed.
Main Results:
- Thirty-one patients with AAH were studied over 10 years.
- Characteristic findings included exclusive apical left ventricular hypertrophy and giant T wave inversion.
- Physical examination revealed faint or absent systolic murmurs and frequently split second heart sound.
- ECG signs showed fluctuation with occasional progression or regression.
- Echocardiography and left ventriculography were crucial for diagnosis and confirmation.
- Complications were infrequent, and the prognosis appeared favorable.
Conclusions:
- Asymmetric apical hypertrophy is a distinct entity within hypertrophic cardiomyopathy, primarily affecting middle-aged men.
- Diagnosis is supported by characteristic ECG findings and confirmed by echocardiography and left ventriculography.
- The condition demonstrates a generally good prognosis with infrequent complications.
- Further research is needed to clarify its relationship with other forms of HCM.
Abstract:
This paper reports 10 years experience of 31 patients with asymmetric apical hypertrophy, in whom left ventricular hypertrophy involved the apex exclusively and giant T wave inversion in the left precordial leads was the characteristic finding. This type of hypertrophic cardiomyopathy was observed predominantly in men over 40 years of age. Family history was negative and patients usually had no complaints. Left ventricular hypertrophy was evident by physical examination as in other forms of hypertrophic cardiomyopathy, but a systolic murmur was faint or absent and the second heart sound was frequently split. Electrocardiographic signs may fluctuate, and occasionally progression or regression occurs. Echocardiography including the two-dimensional method was essential for the diagnosis and left ventriculography was helpful for confirmation. To date complications have been infrequent and the prognosis seems good. The relation of asymmetric apical hypertrophy to other forms of hypertrophic cardiomyopathy is under investigation.