CLINICAL-SIGNIFICANCE OF GIANT NEGATIVE T-WAVES IN HYPERTROPHIC CARDIOMYOPATHY
CLINICAL-SIGNIFICANCE OF GIANT NEGATIVE T-WAVES IN HYPERTROPHIC CARDIOMYOPATHY
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DOI：
10.1016/0735-1097(90)90225-e
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发表时间：
1990-04-01
影响因子：
24
通讯作者：
MCKENNA, WJ
中科院分区：
文献类型：
--
作者：
ALFONSO, F;ANNOPOULOS, PN;MCKENNA, WJ
为探讨西方国家肥厚型心肌病患者出现“巨大”负T波的临床意义，对27例有和56例无“巨大”负T波患者的临床、超声心动图、心电图进行了比较。巨大阴性T波患者在诊断时年龄较大（43 . ±. 15对32 +- 14岁，p < 0.05），具有更大的ECG电压（SV 1 + RV 5 = 57 . ±. 20对37 +- 18 mm，p < 0.001），额面轴更垂直（38.4 ± 0.18 mm，p <0.001）。34对13.4 ±。45 °，P < 0.05）。二维超声心动图显示的左心室壁厚度在二尖瓣水平相似（平均16.5 ± 0.5mm）。4对16.6 +-。3cm），但在乳头肌水平更大（平均20.7 ± 0.3cm）。5对17.6 +-。3 mm，p < 0.01）和心尖部（平均23.3 ± 0.3mm，p <0.01）。5对17.3 +-。巨大阴性T瓣患者（27例中4例[14%] vs 56例中25例[45%]，p <0.001），而左心室舒张末期（44.1 ± 0.3 mm，p <0.001），6对39.6 +-。5 mm，p = 0.01）和收缩末期尺寸（27.8 ± 7 U 4 vs. 24 ± 0.5 mm，p = 0.01）。6mm，p < 0.05）。两组中21%的患者在ECG监测中观察到非持续性室性心动过速。放射性核素心室造影显示两组收缩和舒张功能异常程度相似。两组在随访研究期间的结果没有差异。日本的报告指出，巨大负性T波患者的肥厚仅限于左心室心尖部，症状轻微，预后不良。这项研究表明，在西方，巨大负T波的患者具有更广泛的临床谱，其预后与没有这种T波的患者没有什么不同。
To assess the clinical significance of "giant" negative T waves in patients with hypertrophic cardiomyopathy from Western nations, clinical, echocardiographic, (ECG) monitoring findings were compared in 27 patients with and 56 patients without giant negative T waves. Patients with giant negative T waves were older at diagnosis (43 .+-. 15 versus 32 .+-. 14 years, p < 0.05), had greater ECG voltage (SV1 + RV5 = 57 .+-. 20 versus 37 .+-. 18 mm, p < 0.001) and had a more vertical frontal plane axis (38.4 .+-. 34 versus 13.4 .+-. 45.degree., p < 0.05). Left ventricular wall thickness on two-dimensional echocardiography was similar at the mitral valve level (mean 16.5 .+-. 4 versus 16.6 .+-. 3 cm), but was greater at the papillary muscle level (mean 20.7 .+-. 5 versus 17.6 .+-. 3 mm, p < 0.01) and apex (mean 23.3 .+-. 5 versus 17.3 .+-. 3 mm, p < 0.001) in patients with giant negative T valve (4 [14%) of 27 versus 25 [45%] of 56, p < 0.01), whereas left ventricular end-diastolic (44.1 .+-. 6 versus 39.6 .+-. 5 mm, p = 0.01) and end-systolic dimensions (27.8 7U 4 versus 24 .+-. 6 mm, p < 0.05) were greater in this group. Nonsustained ventricular tachycardia was seen on ECG monitoring in 21% of patients in both groups. Radionuclide ventriculography demonstrated similar degrees of abnormal systolic and diastolic function in both groups. The outcome during follow-up study did not differ between the two groups. Reports from Japan indicate that patients with giant negative T waves have hypertrophy confined to the left ventricular apex, mild symptoms and few adverse prognostic features. This study reveals that patients in the West with giant negative T waves have a wider clinical spectrum and that their prognosis is not different from that of patients without such T waves.