Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
NIHR Biomedical Research Unit, Royal Brompton Hospital Sydney Street, London, SW3 6NP, United Kingdom.
Eur J Radiol. 2014 Feb;83(2):297-302. doi: 10.1016/j.ejrad.2013.10.025. Epub 2013 Nov 7.
To investigate the relationship between T-wave inversions and left ventricular (LV) segmental hypertrophy and myocardial fibrosis assessed by cardiovascular magnetic resonance (CMR) in patients with non-apical hypertrophic cardiomyopathy (HCM).
196 consecutive patients with non-apical HCM underwent late gadolinium enhancement (LGE) CMR and 12-lead electrocardiogram. The distribution and magnitude of LV segmental hypertrophy and LGE were assessed according to the AHA 17-segment model and analyzed in relation to T-wave inversions.
Of 196 HCM patients, 144 (73%) exhibited T-wave inversions. 144 (73%) patients had evidence of myocardial fibrosis as defined by LGE, and the prevalence of LGE was significantly higher in patients with T-wave inversions compared with those without T-wave inversions (78% vs. 59%, P=0.008). T-wave inversions were related to basal anterior and basal anteroseptal LGE (20% vs. 10%, P=0.04 and 68% vs. 46%, P=0.005, respectively). In addition, T-wave inversions were associated with greater basal anteroseptal and basal inferior wall thickness (19.5 ± 4.7 mm vs. 16.7 ± 4.5mm, P<0.001 and 10.9 ± 3.3mm vs. 9.6 ± 3.0mm, P=0.01, respectively). By logistic regression analysis, basal anteroseptal wall thickness and LGE were independent determinants of T-wave inversions (P=0.005, P=0.01, respectively).
T-wave inversions in HCM are associated with LGE and wall thickness of the left ventricular basal segments. Moreover, basal anteroseptal wall thickness and LGE are independent determinants of T-wave inversions.
研究心血管磁共振（CMR）评估的 T 波倒置与非心尖肥厚型心肌病（HCM）患者左心室（LV）节段性肥厚和心肌纤维化之间的关系。
196 例连续非心尖 HCM 患者行延迟钆增强（LGE）CMR 和 12 导联心电图检查。根据 AHA 17 节段模型评估 LV 节段性肥厚和 LGE 的分布和程度，并分析与 T 波倒置的关系。
196 例 HCM 患者中，144 例（73%）出现 T 波倒置。144 例（73%）患者存在 LGE 定义的心肌纤维化证据，T 波倒置患者的 LGE 发生率明显高于无 T 波倒置患者（78% vs. 59%，P=0.008）。T 波倒置与基底前壁和基底前间隔 LGE 相关（20% vs. 10%，P=0.04 和 68% vs. 46%，P=0.005）。此外，T 波倒置与更大的基底前间隔和基底下壁厚度相关（19.5 ± 4.7mm vs. 16.7 ± 4.5mm，P<0.001 和 10.9 ± 3.3mm vs. 9.6 ± 3.0mm，P=0.01）。通过逻辑回归分析，基底前间隔壁厚度和 LGE 是 T 波倒置的独立决定因素（P=0.005，P=0.01）。
HCM 中的 T 波倒置与 LGE 和左心室基底节段壁厚度相关。此外，基底前间隔壁厚度和 LGE 是 T 波倒置的独立决定因素。
