Ohmoto-Sekine Yuki, Suzuki Jun-ichi, Shimamoto Ryoichi, Yamazaki Tadashi, Tsuji Taeko, Nagai Ryozo, Ohtomo Kuni
Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Gend Med. 2007 Sep;4(3):274-83. doi: 10.1016/s1550-8579(07)80046-5.
Despite male predominance in the prevalence of hypertrophic cardiomyopathy (HCM), repeated diagnosis at our institute indicates a possible higher prevalence of deep Q waves with HCM in women.
The current study examined gender similarities and differences in the prevalence of deep Q waves in HCM and in the morphologic and electrocardiographic features of HCM with deep Q waves.
Patients with HCM underwent cardiac magnetic resonance (CMR) imaging to identify the prevalence of deep Q waves in electrocardiographic limb leads, and to analyze the relationship between distribution patterns of deep Q waves and those of the localization of maximum amplitude of left ventricular (LV) hypertrophy. Contiguous LV short-axis images were obtained from the base toward the apex.
Of the 200 consecutive patients (172 males, aged 20-78 years; 28 females, aged 16-79 years) with HCM who underwent CMR imaging, 10 male and 8 female patients had deep Q waves. Deep Q waves were more prevalent in females with HCM than in their male counterparts (28.6% vs 5.8%, respectively; P<0.001). Of the 18 patients with deep Q waves, maximum wall thickness was localized at either the basal anterior wall or the midventricular septum in 9 (90%) of the 10 male patients and 6 (75%) of the 8 female patients. In both sexes, the Q wave distribution pattern of I and aVL and of II and aVF indicated localization of maximum hypertrophy at the midventricular septum in 6 (75%) of the 8 patients with the former pattern, and at the basal anterior wall in 9 (90%) of the 10 patients with the latter pattern.
Diagnostic deep Q waves were detected more frequently in female patients with HCM than in their male counterparts. In HCM with deep Q waves in limb leads, morphologic and electrocardiographic analysis showed similar features in both sexes.
尽管肥厚型心肌病（HCM）的患病率男性占主导，但我院的多次诊断表明，女性HCM患者中出现深Q波的患病率可能更高。
本研究探讨了HCM患者深Q波患病率的性别异同，以及伴有深Q波的HCM患者的形态学和心电图特征。
HCM患者接受心脏磁共振（CMR）成像，以确定心电图肢体导联中深Q波的患病率，并分析深Q波分布模式与左心室（LV）肥厚最大幅度定位之间的关系。从心底向心尖获取连续的LV短轴图像。
在连续接受CMR成像的200例HCM患者中（172例男性，年龄20 - 78岁；28例女性，年龄16 - 79岁），10例男性和8例女性患者有深Q波。女性HCM患者中深Q波比男性更常见（分别为28.6%和5.8%；P<0.001）。在18例有深Q波的患者中，10例男性患者中的9例（90%）和8例女性患者中的6例（75%）最大壁厚位于基底前壁或心室间隔中部。在两性中，I和aVL导联以及II和aVF导联的Q波分布模式表明，在前一种模式的8例患者中有6例（75%）最大肥厚位于心室间隔中部，在后一种模式的10例患者中有9例（90%）最大肥厚位于基底前壁。
女性HCM患者比男性更频繁地检测到诊断性深Q波。在肢体导联有深Q波的HCM患者中，形态学和心电图分析显示两性具有相似特征。
