Arima Naoki, Ochi Yuri, Takahashi Makoto, Moriki Toshihiro, Noguchi Tatsuya, Kubo Toru, Yamasaki Naohito, Kitaoka Hiroaki
Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Oko-cho, Nankoku-shi, 783-8505 Kochi, Japan.
Department of Cardiology, Aki General Hospital, 3-3, Hoei-cho, Aki-shi, 784-0027 Kochi, Japan.
Eur Heart J Case Rep. 2023 Jan 18;7(1):ytad034. doi: 10.1093/ehjcr/ytad034. eCollection 2023 Jan.
In patients with apical hypertrophic cardiomyopathy (HCM), electrocardiography (ECG) often shows left ventricular hypertrophy (LVH) and a negative T wave. A negative T wave often disappears over time due to degeneration of the apical myocardium. However, there are limited reports on the temporary change of a negative T wave in patients with HCM.
We report three apical HCM patients with LVH and T wave inversion on their previous ECG who showed a temporary decrease in the depth of the negative T wave. All of them had significant stenosis of coronary arteries including the left anterior descending artery (LAD). After revascularization for the LAD lesion, their ECG returned to the previous depth of the negative T wave.
The cases presented here suggested that a temporary decrease in the depth of the negative T wave in apical HCM patients may be one of the signs of ischaemia in the anterior-apical region caused by severe stenosis of the LAD.
在肥厚型心肌病（HCM）患者中，心电图（ECG）常显示左心室肥厚（LVH）和T波倒置。由于心尖部心肌退变，倒置的T波常随时间消失。然而，关于HCM患者T波倒置的暂时变化的报道有限。
我们报告了3例既往心电图显示LVH和T波倒置的肥厚型心肌病患者，其倒置T波深度暂时降低。他们均有包括左前降支（LAD）在内的冠状动脉严重狭窄。对LAD病变进行血运重建后，他们的心电图恢复到之前倒置T波的深度。
本文所述病例提示，肥厚型心肌病患者倒置T波深度暂时降低可能是LAD严重狭窄导致的心尖前区缺血的征象之一。
