Notched QRS for the assessment of myocardial fibrosis in hypertrophic cardiomyopathy

Circulation Journal : Official Journal of the Japanese Circulation Society
Tatsuya KawasakiTadaaki Kamitani

Abstract

Patients with hypertrophic cardiomyopathy (HCM) sometimes develop myocardial fibrosis in association with adverse cardiovascular events. Electrocardiography (ECG) could provide helpful information on myocardial fibrosis in HCM, as in coronary artery disease. A total of 60 patients with HCM without bundle branch block underwent cardiac magnetic resonance imaging (CMR). The extent or location of late gadolinium enhancement (LGE) was examined in relation to 12-lead ECG. A notch on QRS was defined as at least 2 consecutive spikes in the same polarity with a reversal of direction ≥90° and the initial negative deflection ≥0.05 mV. LGE was associated with notched QRS, leftward QRS axis, and prolonged QRS duration, but not with any other findings such as abnormal Q waves, R-wave amplitude, or ST-T changes. Notched QRS was most useful in determining the presence or absence of myocardial fibrosis, with a sensitivity of 70% and a specificity of 81% using a cut-off of the number of leads with notched QRS ≥2. The number of notched QRS leads was positively correlated with LGE volume (P<0.01) and the lead distribution of notched QRS was informative about the location of LGE. A notch on QRS was useful in estimating myocardial fibrosis as asses...Continue Reading

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Citations

Nov 10, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Mareomi HamadaShuntaro Ikeda
Jun 24, 2015·Journal of Cardiovascular Electrophysiology·Tetsuo KonnoMasakazu Yamagishi
Sep 20, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshimi SatoSatoaki Matoba
Jan 25, 2020·Cell Stem Cell·Hesham SolimanFabio M V Rossi

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