Correlation of electrocardiographic changes with cardiac magnetic resonance findings in patients with hypertrophic cardiomyopathy

Background: Electrocardiogram is the initial test in the investigation of heart disease. Electrocardiographic changes in hypertrophic cardiomyopathy have no set pattern, and correlates poorly with echocardiographic findings. Cardiac magnetic resonance imaging has been gaining momentum for better ass...

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Detalles Bibliográficos
Autores: Gabriela Miana de Mattos Paixão, Horácio Eduardo Veronesi, Halsted Alarcão Gomes Pereira da Silva, José Nunes de Alencar Neto, Carolina de Paulo Maldi, Luciano de Figueiredo Aguiar Filho, Ibrahim Masciarelli Francisco Pinto, Francisco f. de a. c. de França, Edileide de Barros Correia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:Brasil
Institución:Universidade Federal de Minas Gerais (UFMG)
Repositorio:Repositório Institucional da UFMG
Idioma:inglés
OAI Identifier:oai:repositorio.ufmg.br:1843/59847
Acceso en línea:http://hdl.handle.net/1843/59847
Access Level:acceso abierto
Palabra clave:Hypertrophic cardiomyopathy
Electrocardiography
Magnetic Resonance Spectroscopy
Cardiomyopathy, Hypertrophic
Descripción
Sumario:Background: Electrocardiogram is the initial test in the investigation of heart disease. Electrocardiographic changes in hypertrophic cardiomyopathy have no set pattern, and correlates poorly with echocardiographic findings. Cardiac magnetic resonance imaging has been gaining momentum for better assessment of hypertrophy, as well as the detection of myocardial fibrosis.Objectives: To correlate the electrocardiographic changes with the location of hypertrophy in hypertrophic cardiomyopathy by cardiac magnetic resonance. Methods: This descriptive cross-sectional study evaluated 68 patients with confirmed diagnosis of hypertrophic cardiomyopathy by cardiac magnetic resonance. The patients’ electrocardiogram was compared with the location of the greatest myocardial hypertrophy by cardiac magnetic resonance. Statistical significance level of 5% and 95% confidence interval were adopted.Results: Of 68 patients, 69% had septal hypertrophy, 21% concentric and 10% apical hypertrophies. Concentric hypertrophy showed the greatest myocardial fibrosis mass (p < 0.001) and the greatest R wave size in D1 (p = 0.0280). The amplitudes of R waves in V5 and V6 (p = 0.0391, p = 0.0148) were higher in apical hypertrophy, with statistical significance. Apical hypertrophy was also associated with higher T wave negativity in D1, V5 and V6 (p < 0.001). Strain pattern was found in 100% of the patients with apical hypertrophy (p <0.001).Conclusion: The location of myocardial hypertrophy by cardiac magnetic resonance can be correlated with electrocardiographic changes, especially for apical hypertrophy. (Arq Bras Cardiol. 2018; 110(1):52-59)