RELATIONSHIP BETWEEN ELECTROCARDIOGRAPHIC FEATURES AND DISTRIBUTION OF HYPERTROPHY IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

To evaluate the relationship between the distribution of hypertrophy a nd the electrocardiographic findings in patients with hypertrophic car diomyopathy (HCM), 54 HCM patients were studied using magnetic resonan ce imaging. The patients were divided into 4 groups according to hyper trophic patterns: (i) hypertrophy only at the apex (group I, n=12); (i i) hypertrophy in both the apex and base (group II, n=20); (iii) hyper trophy only at the base with asymmetric septal hypertrophy (ASH) (grou p IIIa, n=17); and (iv) hypertrophy only at the base without ASH (grou p IIIb, n=5). Abnormal Q waves in leads II, III and aVF were found in 1/12, 3/20, 10/17 and 0/5, respectively, and in leads I and aVL they w ere found in 1/12, 8/20, 4/17 and 1/5, respectively. The largest negat ive T waves (mm) were found in group I (group I vs group II vs group m a vs group mb: 15.2+/-5.3, 8.2+/-6.1, 1.6+/-2.0, 0.8+/-1.3, respective ly). The largest positive T waves (mm) were identified in group IIIb ( 3.8+/-3.0, 6.8+/-3.2, 5.8+/-3.6, 9.3+/-2.1, respectively). The presenc e of abnormal Q waves reflected regional hypertrophy in HCM patients b ut the configuration of T waves represented the difference in the loca lization of hypertrophy between the basal and apical segments.