[Distribution of left ventricular hypertrophy and electrocardiographic findings in patient with so-called apical hypertrophic cardiomyopathy].

The distribution of left ventricular hypertrophy determined by two-dimensional echocardiography was compared with the ECG findings of 15 patients with so-called apical hypertrophic cardiomyopathy. In most patients, hypertrophy was localized from the anterior septum at the mid-level of the left ventricle to the apex. Giant negative T waves and ST depressions were observed in II, III, aVF and V4-6 in all cases. Negative U waves in the same leads and prolongation of the QTc were also observed in most cases. The cause of these ECG abnormalities was unknown, but ST-T changes and negative U waves may be related to marked, localized hypertrophy of the apex. The depth of the negative T waves and the ST segments changed significantly by hour, from day to day, or from year to year. However, these changes were not associated with significant changes in blood pressure, cardiothoracic ratio, physical condition or therapy. The cause of these changes was unknown, but alterations in activity of the sympathetic nervous system may be one possible cause. In patients with monthly or yearly changes in ST-T, the progression of hypertrophy may also be the cause. ST-T variations revealed in this study might be one of the causes for the different incidences of giant negative T waves in the reports with apical hypertrophic cardiomyopathy. In some patients, an exercise test was positive, but, the coronary angiogram and left ventriculogram were normal for all patients.