PhD Scientific Days 2020

Clinical Medicine II. Posters

Electrocardiographic Predictors of Myocardial Fibrosis and Hypertrophy in Hypertrophic Cardiomyopathy

Előadó neve

Dr. Dohy, Zsófia

Előadó munkahelye

Semmelweis University, Heart and Vascular Center

Előadó telefonszáma

0620/6701228

Előadó e-mail címe

dohyzsofi@gmail.com

Az előadás címe

Electrocardiographic Predictors of Myocardial Fibrosis and Hypertrophy in Hypertrophic Cardiomyopathy

Szerző(k) neve és munkahelye

Zsofia Dohy1, Csilla Czimbalmos1, Ibolya Csecs1, Attila Toth1, Ferenc Imre Suhai1, Viktor Horvath1, Liliana Szabo1, Andras Vereckei2, Bela Merkely1, Hajnalka Vago1
1Heart and Vascular Center, Semmelweis University, Budapest
²3rd Department of Internal Medicine, Semmelweis University, Budapest

Szekció

Clinical Medicine II. Posters

Language of the presentation

Hungarian

Section, first choice

Clinical Medicine

Section, second choice

Clinical Medicine

Összefoglaló szövege

Structural myocardial changes in hypertrophic cardiomyopathy (HCM) are associated with different abnormalities on electrocardiographs (ECGs). The diagnostic value of the ECG voltage criteria used to screen for left ventricular hypertrophy (LVH) may depend on the presence and degree of myocardial fibrosis. Fibrosis can cause other changes in ECG parameters, such as pathological Q waves, fragmented QRS (fQRS) or repolarization abnormalities.
The aim of our study was to investigate the diagnostic accuracy of ECG hypertrophy criteria using CMR to diagnose LVH and the impact of myocardial fibrosis on these criteria and to define ECG predictors of LVH and myocardial fibrosis in patients with HCM.
We investigated 85 patients with HCM who underwent cardiac magnetic resonance imaging with late gadolinium enhancement (LGE) and standard 12-lead ECG. On the ECG, depolarization and repolarization abnormalities, the Sokolow-Lyon index, the Cornell index and the Romhilt-Estes score were evaluated. The left ventricular ejection fraction, volumes, myocardial mass (LVM) and maximal end-diastolic wall thickness were quantified. LVM was evaluated with the exclusion (conventional method) and inclusion (threshold-based method) of the trabeculae and papillary muscles. Myocardial fibrosis was quantified on LGE images.
The Romhilt-Estes score was positive in 74% of the cases and had the strongest correlation with the LVM index (LVMi) (p<0.001; r=0.39). Weak correlation was found both between LVMi and the Cornell index (p<0.01; r=0.28), and LVMi and the Sokolow-Lyon index (p<0.05; r=0.22). The Cornell index correlated negatively with the amount of fibrosis (p<0.05; r=-0.22), the Romhilt-Estes score was independent of fibrosis (p=0.604; r=0.06). The presence of fQRS or strain pattern associated independently with an increased amount of myocardial fibrosis, they predicted additional 5.6% and 5.2% fibrosis of LVM, respectively (p<0.01). Our results were independent of the method of LVM measurement and the observer’s experience.
The Romhilt-Estes score is the most sensitive ECG criterion to detect LVH in HCM patients, as myocardial fibrosis has no effect on this criterion. The presence of fQRS and strain pattern predicts myocardial fibrosis.
Supported by the ÚNKP-19-3-I New National Excellence Program of the Ministry for Innovation and Technology

Additional Information

Supervisor: Hajnalka Vágó
vagoha@gmail.com

Bemutatás módja

Poszter

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

2745

Start

13:02

End

13:05

Authors (legacy)

Zsofia Dohy1, Csilla Czimbalmos1, Ibolya Csecs1, Attila Toth1, Ferenc Imre Suhai1, Viktor Horvath1, Liliana Szabo1, Andras Vereckei2, Bela Merkely1, Hajnalka Vago1
1Heart and Vascular Center, Semmelweis University, Budapest
²3rd Department of Internal Medicine, Semmelweis University, Budapest