Kosin Medical Journal (고신대학교 의과대학 학술지)

Kosin University College of Medicine (고신대학교 의과대학)
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The association between T wave inversion and apical hypertrophic cardiomyopathy

  • Chae, Cheol Byoung (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Ha, Ju Hee (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Kim, Jun Ho (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Lee, Jae Joon (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Choi, Han Il (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Park, Ki Beom (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Kim, Jin Hee (Division of Cardiology, Department of Internal Medicine, Busan medical center) ;
  • Choi, Jung Hyun (Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital)
  • Received : 2016.09.21
  • Accepted : 2016.10.25
  • Published : 2018.12.31
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Abstract

Objectives: Electrocardiograhy (ECG) is the first step in hypertrophic cardiomyopathy (HCMP) diagnosis. For various reasons, the T wave inversion (TWI) and ECG change with time and HCMP is not easy to diagnosis. The aim of this retrospective study was to investigate the association between TWI on ECG and apical HCMP. Methods: A total of 4,730 ECGs presenting TWI from January 2011 to March 2013 in Pusan National University Hospital were enrolled. 133 patients who were examined by both echocardiography and coronary angiogram were analyzed. Patients were divided into two groups: Group A (TWI ${\geq}$ 10 mm) and Group B (5 mm ${\leq}$ TWI < 10 mm). HCMP is defined by a wall thickness ${\geq}15mm$ in one or more LV myocardial segments. Apical HCMP is defined to be hypertrophy that is confined to LV apex. The patients who had ECGs with at least one month interval were divided 3 groups: Normal T wave, Abnormal T wave, and Persistent TWI. The prevalence of Apical HCMP and coronary artery disease (CAD) was reviewed among the three groups. Results: In this study there were a total 133 patients, with patients divided into Group A which had 15 patients and Group B which had 118 patients. Among the 23 patients with apical HCMP, three patients were Group A and twenty patients were Group B (P = 0.769). Regarding constancy of TWI, persistent TWI group was higher in apical HCMP than in other groups (P = 0.038). CAD had no difference between groups (P = 0.889). Conclusions: T wave negativity was not associated with incidence of apical HCMP. However, apical HCMP was diagnosed more frequently in patients with persistent TWI. Further follow up echocardiographic study is needed to evaluate the progression of apical HCMP in patients with TWI.

Keywords

References

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