Takashi Nishijo

Hypertrophic nonobstructive cardiomyopathy with giant negative T waves (apical hypertrophy): ventriculographic and echocardiographic features in 30 patients.

Abstract In 30 of 1,002 consecutive patients who had left heart catheterization and cineangiography for evaluation of either ischemic heart disease or cardiomyopathy the electrocardiogram showed giant negative T waves (greater than 10 mm) associated with high QRS voltage (R wave greater than 26 mm in lead V 5 or the sum of the S wave in lead V 1 and the R wave in lead V 5 35 mm or more) in the precordial leads despite absence of hypertension or significant coronary artery disease. In all 30 patients a characteristic spade-like configuration (concentric apical hypertrophy) was observed in the right anterior oblique ventriculogram at end-diastole as well as in the long axis two dimensional echocardiogram. The average apical thickness in these patients (24.8 ± 6.6 mm) was significantly greater than that in normal subjects (9.4 ± 3.1 mm) ( P P P P P It is concluded that these 30 patients have nonobstructive hypertrophic cardiomyopathy with marked concentric hypertrophy in the apex (apical hypertrophic type) and with a different septal shape and contraction pattern from those seen in the obstructive type. This type of hypertrophy appears to be a fairly common type of hypertrophic cardiomyopathy in Japan.