Objectives We sought to compare the clinical, morphologic and functional characteristics by late gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM) with and without negative T waves.
Methods 275 consecutive patients with HCM underwent LGE CMR, echocardiography and 12-lead electrocardiogram (ECG). The clinical data, morphologic and functional characteristics such as Left ventricular (LV) function, volumes, myocardial thickness and LGE score were assessed and analysed in relation to negative T waves.
Results Episodes of negative T waves were documented in 204 patients (74%), these patients showed significantly higher prevalence of LGE (69.1% versus 54.9%, P = 0.03). The LGE score and mean LV wall thickness assessed by CMR were similar at apex (p > 0.05, respectively), apical (p > 0.05, respectively) and middle level (p > 0.05, respectively), but were greater at the basal level (3.5 ± 3.7 versus 2.5 ± 3.1, P = 0.03 and 13.2 ± 3.3mm versus 12.3 ± 2.7mm, P = 0.018, respectively) in patients with negative T waves. When adjusting for age, gender and body mass index (BMI), both maximal and mean LV wall thickness significantly correlated to LV LGE score (r = 0.54, p<0.001 and r = 0.45, p<0.001, respectively). On multivariate analysis, basal inferior (Segment 4, S4) wall thickness and basal anteroseptal (Segment 2, S2) LGE score were independently associated with negative T waves in HCM patients (P = 0.019, P = 0.035, respectively). Receiver operating characteristic curve analysis indicated moderate predictive performance of S4 wall thickness and S2 LGE score (AUC = 0.61 and 0.58, respectively) with respect to negative T waves.
Conclusions The present study demonstrates negative T waves in HCM patients are associated with greater LGE and wall thickness at the basal level of left ventricular. Both basal anteroseptal LGE score and basal inferior wall thickness are independent determinants of negative T waves in HCM patients. The findings may reveal the interrelation between negative T waves and LV basal segments in HCM patients.
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