Association of ST elevation with apical aneurysm in hypertrophic cardiomyopathy


Ozeke O., Ertan C., Keskin G., Deveci B., Cay S., Ozcan F., ...More

Indian Heart Journal, vol.67, no.5, pp.434-439, 2015 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 67 Issue: 5
  • Publication Date: 2015
  • Doi Number: 10.1016/j.ihj.2015.05.019
  • Journal Name: Indian Heart Journal
  • Journal Indexes: Scopus
  • Page Numbers: pp.434-439
  • Keywords: Apical aneurysm, Hypertophic cardiomyopathy, ST elevation
  • Lokman Hekim University Affiliated: No

Abstract

© 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.Objectives Apical aneurysms in patients with hypertrophic cardiomyopathy (HCM) represent an underrecognized but clinically important subset of HCM patients. However it may be frequently missed by echocardiography because of poor image quality of left ventricular apex. We aimed to compare electrocardiographic STE in HCM patients with and without apical aneurysm. Methods We developed this clinical review using an extensive MEDLINE review of the literature and data from our laboratories; and some electrocardiographic parameters including STE were analysed in HCM patients with and without apical aneurysm. Results There were 29 HCM patients without apical aneurysm (Group 1; 52.6 ± 17.7years, 69% male) and 28 HCM patients with apical aneurysm (Group 2; 59.6 ± 13.2years, 57% male). The STE in V4-6 derivations were statistically more frequent in patients with apical aneurysm compared to those without aneurysm (93% vs 7%, p < 0.001). There was a positive correlation between the presence of the STE in V4-6 derivations and the presence of the apical aneurysm (Spearman's ρ = 0.895, p < 0.001). Conclusions Clinicians and specifically echocardiographers must pay special attention on the electrocardiography to correctly detect the frequently overlooked apical aneurysm in HCM patients, and should be careful for apical aneurysm particularly in the presence of STE in V4-6 derivations.