Louie E K, Maron B J
Ann Intern Med. 1987 May;106(5):663-70. doi: 10.7326/0003-4819-106-5-663.
Of 965 patients with hypertrophic cardiomyopathy evaluated by echocardiography at the National Institutes of Health during a 7-year period, 23 (2%) had a nonobstructive morphologic form, in which wall thickening occurred predominantly in the apical (distal) portion of the left ventricle. The patients ranged in age from 15 to 69 years (mean, 37) and were predominantly male (14 patients) and white (only 1 was of oriental descent). Fifteen patients had significant functional limitation, which was usually caused by exertional dyspnea and fatigue. Several electrocardiographic patterns were identified in the study group, but only 4 of these patients showed "giant" negative T waves. Only 3 patients had a morphologic expression of apical hypertrophy that closely resembled that described in Japanese patients--that is, hypertrophy that was particularly localized and confined to the true left ventricular apex (2 of these patients had giant negative T waves). Hence, hypertrophy located predominantly in the distal left ventricle was uncommon in our primarily North American patient population with hypertrophic cardiomyopathy. Most of our patients showed morphologic and clinical features that were dissimilar to those found previously in Japanese patients with apical hypertrophy.
在国立卫生研究院7年期间通过超声心动图评估的965例肥厚型心肌病患者中，23例（2%）为非梗阻性形态类型，其室壁增厚主要发生在左心室的心尖（远端）部分。患者年龄在15至69岁之间（平均37岁），以男性为主（14例患者），且大多为白人（仅1例为东方人后裔）。15例患者有明显的功能受限，通常由劳力性呼吸困难和疲劳引起。研究组发现了几种心电图模式，但这些患者中只有4例显示“巨大”负T波。只有3例患者的心尖肥厚形态表现与日本患者中描述的相似，即肥厚特别局限于真正的左心室心尖（其中2例患者有巨大负T波）。因此，在我们以北美为主的肥厚型心肌病患者群体中，主要位于左心室远端的肥厚并不常见。我们的大多数患者表现出的形态和临床特征与先前日本心尖肥厚患者中发现的不同。
