Fujii J, Saihara S, Sawada H, Aizawa T, Kato K
J Cardiogr Suppl. 1985(6):23-33.
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.
通过二维超声心动图确定的左心室肥厚分布与15例所谓的肥厚型心肌病患者的心电图结果进行了比较。在大多数患者中，肥厚从左心室中层的前间隔延伸至心尖。所有病例在II、III、aVF及V4 - 6导联均观察到巨大负向T波和ST段压低。大多数病例在相同导联还观察到负向U波以及QTc延长。这些心电图异常的原因尚不清楚，但ST - T改变和负向U波可能与心尖部明显的局限性肥厚有关。负向T波和ST段的深度随时间（小时、天或年）有显著变化。然而，这些变化与血压、心胸比率、身体状况或治疗的显著变化无关。这些变化的原因尚不清楚，但交感神经系统活动的改变可能是一个可能的原因。在ST - T有每月或每年变化的患者中，肥厚的进展也可能是原因。本研究中揭示的ST - T变化可能是肥厚型心肌病报道中巨大负向T波发生率不同的原因之一。在一些患者中，运动试验呈阳性，但所有患者的冠状动脉造影和左心室造影均正常。
