[The echocardiographic diagnostic characteristics and follow-up of apical hypertrophic cardiomyopathy.].

OBJECTIVE

To evaluate the echocardiographic features of apical hypertrophic cardiomyopathy (ApHCM).

METHODS

Twenty-seven patients with ApHCM including 21 men and 6 women, average age (42.7 +/- 5.1) years old were followed up from 1995 to 2008 to investigate the clinical, electrocardiographic and echocardiographic features.

RESULTS

The major features of ECG were increased R amplitude (V(4) > V(5) > V(3)) and inverteted T wave (especially in V(3-5) leads and the voltage of the inverteted T waves may be up to >/= 10 mm). The major feature of echocardiography was the thickening of left ventricular apical wall to 15 - 37 (18.0 +/- 3.3) mm. The final follow up showed that the mean thickness of the apical wall was (19.7 +/- 3.7) mm. The ratio of the thickness of left ventricular apical wall to posterior wall before and after the follow up was 1.7 +/- 0.3 and 1.9 +/- 0.9 respectively, with significant statistical difference (P < 0.05). There was no difference in the left ventricular end-diastolic dimension and left ventricular ejection fraction. The main cardiovascular events were atrial fibrillation (16 cases), heart failure of NYHA III-IV class (3 cases), anterior wall myocardial infarction (1 case) and sudden death (1 case).

CONCLUSIONS

The final diagnosis of ApHCM depends on the characteristic inverteted T wave in ECG and apical hypertrophy in echocardiography. The prognosis of ApHCM is rather good for its progression is relatively slow.