Role of Surface Electrocardiography in Differentiation between Obstructive and Non-obstructive Hypertrophic Cardiomyopathy

  • Mahsa Nourani Department of Cardiac Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Mehdi Mirzaie Department of Cardiac Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Mohammad Ali Sadr-Ameli Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Amirfarjam Fazelifar Department of Cardiac Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Majid Haghjoo Department of Cardiac Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Keywords: Cardiomyopathy; Hypertrophic; Electrocardiography

Abstract

 

Background: Electrocardiography (ECG), as an easily accessible modality, is usually helpful in hypertrophic cardiomyopathy (HCM) diagnosis. The purpose of this study was to evaluate the role of ECG in differentiating between obstructive (OHCM) and non-obstructive (NOHCM) HCM.

Methods: The present study is a cross-sectional analysis of HCM patients referred to our center between 2008 and 2017. The study variables included age, sex, clinical presentation, medications, and ECG characteristics including PR interval, QRS width, QTc duration, Tpeak-Tend interval, QRS axis, QRS transition, ventricular hypertrophies, atrial abnormalities, ST-T abnormalities, and abnormal Q waves.

Results: The HCM sample consisted of 200 patients (55% males; age 45.60±15.50 y) from our HCM database. We compared the clinical and ECG characteristics of 143 NOHCM patients with those of 57 OHCM patients. The OHCM group was significantly younger than the NOHCM group (age =41.7 vs 47.0 y; P=0.016). The initial clinical presentation was similar between the 2 forms (P>0.05), and palpitations were the dominant symptom. Baseline ECG intervals, including PR (155.6 vs 157.9 ms), QRS (82.5 vs 82.0 ms), and QTc (430.5 vs 433.0 ms), were similar (all Ps>0.050). There were no differences regarding baseline rhythm, atrial abnormalities, QRS transition, ventricular hypertrophies, axis changes, ST-T changes, and abnormal Q waves between the HCM groups (all Ps>0.05).

Conclusion: The present study showed that standard 12-lead ECG had no role in distinguishing patients with the obstructive and non-obstructive forms of HCM.

Published
2023-04-29
Section
Articles