Giant T wave inversion as a manifestation of asymmetrical apical hypertrophy (AAH) of the left ventricle. Echocardiographic and ultrasono-cardiotomographic study.
Giant T wave inversion as a manifestation of asymmetrical apical hypertrophy (AAH) of the left ventricle. Echocardiographic and ultrasono-cardiotomographic study.
复制标题
巨大 T 波倒置是左心室不对称心尖肥大 (AAH) 的表现。
DOI：
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发表时间：
1976
期刊：
影响因子：
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通讯作者：
K. Amano
中科院分区：
文献类型：
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作者：
T. Sakamoto;C. Tei;M. Murayama;H. Ichiyasu;Y. Hada;Terumi Hayashi;K. Amano
对9例不明原因的巨大T波倒置患者进行左心室超声心动图和超声心动断层扫描，以寻找可能的肌肉异常。左心前导联深度倒置T波超过1.2 mV（平均1.63 mV）。所有病例均有不明原因心电图左心室肥厚，且无缺血发作。测量左心室短轴的传统回波束方向显示室间隔（IVS）和后壁（PW）的厚度和运动几乎正常，因此这些病例的报告经常在正常范围内。然而，超声心脏断层扫描（B 区扫描）揭示了左心室心尖附近相当局部的肥厚，并且当向心尖进行扫描时，传统超声心动图也显示了 IVS 或 PW 或两者在乳头肌插入点下方的相同区域（不对称心尖肥大：AAH）。对 9 例 IHSS 病例的对照研究显示，间隔不对称肥厚 (ASH)，从基底到心尖的 IVS 几乎同样肥厚。所有病例均有T波倒置，但程度较轻。 3例具有与AAH相一致的较深T波，且心尖部也有相当程度的肥大（IHSS的不寻常型，即介于AAH和ASH之间的中间型）。倒置T波的深度和心尖/中壁厚度比之间的密切关系表明，肥大的心尖肌肉组织的恢复过程的改变是造成迄今为止尚未解决的巨大T波倒置的原因。在 AAH 与其他形式的肥厚型心肌病之间的联系被揭示之前，具有这种 T 波和心尖肥大的病例可被称为不对称性心尖肥大 (AAH)。
Left ventricular scanning by echocardiography and ultrasono-cardiotomography was performed to search the possible muscular abnormality in 9 cases with giant T wave inversion without documented cause. The deeply inverted T wave was more than 1.2 mV (average was 1.63 mV) in the left precordial leads. All the cases had electrocardiographic left ventricular hypertrophy of obscure origin and ischemic episode was absent. Conventional echo beam direction to measure the short axis of the left ventricle disclosed almost normal thickness and movement of both interventricular septum (IVS) and the posterior wasll (PW), so that the report of these cases is frequently within normal limits. However, ultrasono-cardiotomography (sector B scan) disclosed the fairly localized hypertrophy near the left ventricular apex, and conventional echocardiography also revealed the same area of either IVS or PW or both below the insertion of the papillary muscles, when the scanning towards the apex was performed (asymmetrical apical hypertrophy: AAH). Control study of 9 cases with IHSS showed asymmetrical septal hypertrophy (ASH) with almost equally hypertrophied IVS from base to apex. All cases had inverted T waves, but these were of lesser degree. Three cases had relatively deep T wave compatible with those of AAH, and these cases also had the apical hypertrophy of considerable degree (unusual type of IHSS, i.e., intermediate type between AAH and ASH). The close relationship between the depth of the inverted T waves and the Apex/Mid wall thickness ratios suggests that the altered recovery process of the hypertrophied apical musculature is responsible for the giant T wave inversion of heretofore unsolved origin. Until the connective link of AAH to the other forms of hypertrophic cardiomyopathy is disclosed, the cases with such a T wave and the apical hypertrophy may be designated as asymmetrical apical hypertrophy (AAH).