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ȣ - 490236 261 |
Phenotypic Spectrum and Clinical Characteristics of Apical Hypertrophic Cardiomyopathy in Korean (Multicenter Study) |
Cardiology Division, Yonsei Cardiovascular Center¹ , Asan Medical Center² , Samsung Medical Center³ , Seoul National University College of Medicine⁴ |
Se-Joong Rim¹, Eui-Young Choi¹, Jong-Won Ha¹ , Duk-Hyun Kang² , Jae-Kwan Song² , Sang-Chol Lee³ , Seung Woo Park³ , Yong-Jin Kim⁴, Dae-Won Sohn⁴, Namsik Chung ¹ |
Background: The aim of this study was to describe the phenotypic spectrum and clinical characteristics of apical hypertrophic cardiomyopathy (ApHCM) in Korean. Methods: For the 200 consecutive patients (58.9±11.2 years;156 men) with ApHCM, patterns of left ventricular hypertrophy by measuring end-diastolic wall thickness of all 16 segments, echo-Doppler parameters, ECG findings, clinical findings and cardiovascular comorbidity were analyzed. Results : ApHCM was classified into 3 types according to patterns of hypertrophy. Focal type (n=84) was defined as hypertrophy confined to 2 or less apical segments, diffuse (n=74) as more than 2 apical segments and mixed (n=42) as apical hypertrophy combined with asymmetrical septal hypertrophy but maximal thickness in the apical segment. Lateral apical segment was the most predominant site of maximal hypertrophy. (122 patients, 61%, mean thickness:17.8 mm). Incidence of atrial fibrillation (AF) and left atrial volume index (LAVi) were significantly different among subtypes. The degree of maximal negative T wave (maxNT) (r=0.205,p=0.006) and sum of precordial (V3-6) negative T waves (sumNT) (r=0.245,p=0.001) significantly correlated with maximal thickness of apex. Conclusions: ApHCM contains several spectrums of morphologic phenotype and this subtyping has value on determining the clinical characteristics.
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Focal type
(n=84) |
Diffuse type
(n=74) |
Mixed type
(n=42) |
Total
(n=200) |
Age (yr) |
58.9±11.6 |
59.2±10.4 |
58.9±12.3 |
59.0±11.2 |
Male
(%) |
65(77) |
55(74) |
36(86) |
156(78) |
Hypertension
(%) |
46(55) |
37(50) |
21(50) |
104(52) |
Giant NT
(%) |
33(39) |
38(51) |
16(38) |
87(44) |
MaxNT
(mm) |
10.0±5.8 |
11.2±6.5 |
9.5±5.8 |
10.4±6.1 |
SumNT
(mm) |
27.8±17.0 |
31.7±21.0 |
27.2±19.4 |
29.2±19.0 |
AF (%) |
5(6) |
8(11) |
9(22)* |
22(11) |
Max.apical thickenss (mm) |
17.8±2.7 |
19.0±3.0 |
19.7±2.6 |
18.6±2.9 |
LAVi (ml/m2) |
31.0±12.3 |
36.1±14.8* |
44.3±17.0**† |
34.9±14.7 |
E/E’ |
14.3±5.6 |
13.7±5.4 |
15.4±6.2 |
14.2±5.6 |
*p <0.05, **p<0.001 vs focal type,
†p<0.05 vs diffuse type, Giant
NT:
>10mm NT
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