Myocardial Repolarization Dispersion and Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy

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  • Magrì Damiano
    Department of Clinical and Molecular Medicine, Sapienza University
  • De Cecco Carlo Nicola
    Department of Radiological Sciences, Sapienza University Department of Radiology and Radiological Sciences, Medical University of South Carolina
  • Piccirillo Gianfranco
    Department of Cardiovascular, Respiratory, Anesthesiological, Nephrologic and Geriatrics Sciences, Sapienza University
  • Mastromarino Vittoria
    Department of Clinical and Molecular Medicine, Sapienza University
  • Serdoz Andrea
    Department of Clinical and Molecular Medicine, Sapienza University
  • Muscogiuri Giuseppe
    Department of Radiological Sciences, Sapienza University
  • Ricotta Agnese
    Department of Clinical and Molecular Medicine, Sapienza University
  • Gregori Mario
    Department of Clinical and Molecular Medicine, Sapienza University
  • Marino Laura
    Department of Clinical and Molecular Medicine, Sapienza University
  • Cauti Filippo Maria
    Department of Clinical and Molecular Medicine, Sapienza University
  • Pagannone Erika
    Department of Clinical and Molecular Medicine, Sapienza University
  • Musumeci Maria Beatrice
    Department of Clinical and Molecular Medicine, Sapienza University
  • Maruotti Antonello
    Department of Political Sciences, University Roma Tre Southampton Statistical Sciences Research Institute and School of Mathematics, University of Southampton
  • Autore Camillo
    Department of Clinical and Molecular Medicine, Sapienza University

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Background: Growing evidence suggests that late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) is an additive marker of disease severity, and possibly of arrhythmic risk, in hypertrophic cardiomyopathy (HCM). We investigated the possible relationship between LGE and markers of myocardial repolarization dispersion in HCM. Methods and Results: Eighty-five HCM outpatients underwent CMR and short-period electrocardiogram analysis to calculate the temporal myocardial repolarization dispersion through the QT variance normalized for QT mean (QTVN) and the QT variability index (QTVI). The QT dispersion in the spatial domain was also obtained. Patients with LGE (62%) had higher left atrial volume, maximum wall thickness, and left ventricular mass (P<0.0001), as well as a greater prevalence of non-sustained ventricular tachycardia (P<0.0001) and hypotensive blood pressure response (P=0.044). Both QTVN and QTVI were higher in the group with LGE (P<0.0001). At multivariate analysis, using QTVI as the dependent variable, %LGE (P<0.0001), age (P<0.0001), left ventricular outflow obstruction (P=0.038), and sudden cardiac death risk factor burden (P=0.020) reached statistical significance. Otherwise, only %LGE (P=0.005) and left ventricular mass index (P=0.015) remained associated with QTVN. Conclusions: Temporal myocardial repolarization dispersion correlates with LGE extent. Whether these variables could be useful in HCM clinical management warrants confirmation by larger prospective studies.  (Circ J 2014; 78: 1216–1223)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 78 (5), 1216-1223, 2014

    一般社団法人 日本循環器学会

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