PMID- 26740481
OWN - NLM
STAT- MEDLINE
DCOM- 20170717
LR  - 20180130
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 102
IP  - 4
DP  - 2016 Feb 15
TI  - Unexpectedly low left ventricular voltage on ECG in hypertrophic cardiomyopathy.
PG  - 292-7
LID - 10.1136/heartjnl-2015-308633 [doi]
AB  - OBJECTIVE: While late gadolinium enhancement (LGE) in paediatric patients with 
      hypertrophic cardiomyopathy (HCM) is reported as similar to adults, the 
      relationship between LGE and ECG findings in paediatric patients is unknown. We 
      sought to evaluate the relationship between LGE on cardiac MRI and LV precordial 
      voltage on ECG. METHODS: This was a retrospective analysis of paediatric patients 
      with HCM aged 9-21 years with cardiac MRI and ECG completed within 60 days of 
      each other. Demographic, MRI and ECG data were compared between patients with and 
      without LGE. Maximal diastolic septal thickness, septal to free wall ratio and 
      LGE presence were compared with LV precordial voltage (SV1, RV6 and SV1+RV6). 
      RESULTS: This study included 37 patients (33 male). Mean age was 15.8+/-2.8 years. 
      Mean maximal LV diastolic septal thickness was 22.1+/-7.9 mm. Mean septal to free 
      wall ratio was 2.4+/-1.6 mm. LGE was present in 18 patients, with 16 isolated to 
      the ventricular septum. Comparing patients with and without LGE, there was no 
      difference in age (p=0.2) or body surface area (p=0.9). However, the presence of 
      LGE was associated with significantly increased septal thickness (p=0.03), yet 
      decreased voltages in SV1 (p=0.005), RV6 (p=0.005) and SV1+RV6 (p=0.002) despite 
      increased septal dimensions. CONCLUSIONS: A significant inverse relationship 
      exists between LGE presence and LV precordial voltage in this population. 
      Unexpectedly low LV precordial voltages in patients with HCM may serve as a 
      clinical surrogate marker for myocardial fibrosis and potential loss of viable 
      myocardial tissue.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/
FAU - Guerrier, Karine
AU  - Guerrier K
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
FAU - Madueme, Peace C
AU  - Madueme PC
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
FAU - Jefferies, John L
AU  - Jefferies JL
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
FAU - Anderson, Jeffrey B
AU  - Anderson JB
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
FAU - Spar, David S
AU  - Spar DS
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
FAU - Knilans, Timothy K
AU  - Knilans TK
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
FAU - Czosek, Richard J
AU  - Czosek RJ
AD  - Department of Cardiology, Cincinnati Children's Hospital Medical Center, The 
      Heart Institute, Cincinnati, Ohio, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20160106
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Action Potentials
MH  - Adolescent
MH  - Cardiomyopathy, Hypertrophic/*diagnosis/diagnostic 
      imaging/pathology/physiopathology
MH  - Child
MH  - *Electrocardiography
MH  - Female
MH  - Fibrosis
MH  - Heart Ventricles/diagnostic imaging/pathology/*physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Ohio
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Tissue Survival
MH  - Ventricular Septum/diagnostic imaging/pathology/physiopathology
MH  - Young Adult
EDAT- 2016/01/08 06:00
MHDA- 2017/07/18 06:00
CRDT- 2016/01/08 06:00
PHST- 2015/09/01 00:00 [received]
PHST- 2015/12/11 00:00 [accepted]
PHST- 2016/01/08 06:00 [entrez]
PHST- 2016/01/08 06:00 [pubmed]
PHST- 2017/07/18 06:00 [medline]
AID - heartjnl-2015-308633 [pii]
AID - 10.1136/heartjnl-2015-308633 [doi]
PST - ppublish
SO  - Heart. 2016 Feb 15;102(4):292-7. doi: 10.1136/heartjnl-2015-308633. Epub 2016 Jan 
      6.