Limitations of electrocardiographic criteria of left ventricular hypertrophy in differentiation between hypertrophic cardiomyopathy, cardiac amyloidosis and Fabry disease

• Authors: Mateusz Tometczak , Judyta Znamirowska , Justyna Topa , Patrycja Pastor , Damian Waksmundzki , Adam Grzebinoga , Katarzyna Mizia-Stec

Title variants

PL

Ograniczenia elektrokardiograficznych kryteriów przerostu lewej komory serca w różnicowaniu kardiomiopatii przerostowej, amyloidozy serca oraz choroby Fabry’ego

Abstracts

PL

WSTĘP: Przerost lewej komory (left ventricular hypertrophy – LVH) jest powszechną patologią i powinien być rozróżniany za pomocą metod inwazyjnych i nieinwazyjnych. Elektrokardiografia (electrocardiography – ECG) jest metodą pierwszego wyboru w klinicznej ocenie pacjentów z LVH.
MATERIAŁ I METODY: Przeprowadzono retrospektywną analizę 77 pacjentów (wiek: 54.1 ± 16.3; 50,6% mężczyzn) z cechami przerostu serca w badaniu echokardiograficznym. Populację podzielono na trzy podgrupy: 60 pacjentów z kardiomiopatią przerostową (hypertrophic cardiomyopathy – HCM), 11 z amyloidozą serca (cardiac amyloidosis – CA) i 6 z chorobą Fabry’ego (Fabry disease – FD). Oceniono zapisy ECG oraz zweryfikowano obecność i częstość występowania ośmiu kryteriów LVH.
WYNIKI: W badanej populacji kryteria LVH ECG były spełnione u 67,6% pacjentów z HCM, 53,8% z CA i 57,1% z FD. Analiza liczby kryteriów LVH ujawniła: żadnego kryterium nie spełniało 32,4% pacjentów z HCM, 46,2% z CA oraz 42,9% z FD; 1 kryterium spełniało 21,1% pacjentów z HCM, 46,2% z CA oraz 14,3% z FD; 2–4 kryteria stwierdzono u 33,8% pacjentów z HCM, 7,7% z CA oraz 42,9% z FD; 5–7 kryteriów występowało u 12,7% pacjentów z HCM i u żadnego pacjenta z CA i FD. Żaden pacjent nie spełniał ośmiu kryteriów.
WNIOSKI: Elektrokardiograficzne kryteria LVH nie są swoistymi wykładnikami LVH. Różnice pomiędzy echokardiografią przezklatkową (transthoracic echocardiography – TTE) oraz zmianami elektrokardiograficznymi są charakterystyczne dla CA oraz FD, co może budzić podejrzenie wystąpienia tych chorób. Brak spełnionych kryteriów LVH w ECG nie wyklucza tych diagnoz.

EN

INTRODUCTION: Left ventricular hypertrophy (LVH) is a common pathology and should be differentiated using non-invasive and invasive methods. Electrocardiography (ECG) is the first choice method for the clinical evaluation of patients with LVH.
MATERIAL AND METHODS: A retrospective analysis of 77 patients (pts; age: 54.1 ± 16.3; 50.6% men) with features of cardiac hypertrophy in an echocardiographic examination was performed. The population was divided into three subgroups: 60 pts with hypertrophic cardiomyopathy (HCM), 11 pts with cardiac amyloidosis (CA) and 6 pts with Fabry disease (FD). Multiple ECG records were evaluated and the presence and frequency of eight different LVH criteria were verified.
RESULTS: Among the study population LVH criteria were present in 67.6% pts with HCM, 53.8% pts with CA and 57.1% pts with FD. Analysis of the number of LVH ECG criteria revealed: none of LVH ECG criteria: in 32.4% pts of HCM, in 46.2% pts with CA, in 42.9% pts with FD; 1 LVH ECG criterion in 21.1% pts with HCM, 46.2% pts with CA and 14.3% pts with FD; 2–4 criteria in 33.8% pts with HCM, 7.7% pts with CA and 42.9% pts with FD; 5–7 criteria in 12.7% pts with HCM and no pts with CA or FD. No patient fulfilled the eight LVH ECG criteria.
CONCLUSIONS: Electrocardiographic LVH criteria are not sensitive indicators of LVH. The mismatch between transthoracic echocardiography (TTE) and ECG findings is characteristic for CA and FD that may raise the suspicion of these diseases. The lack of LVH ECG criteria do not exclude these diagnoses.

Keywords

EN

LVH ECG criteria; hypertrophic cardiomyopathy; amyloidosis; Fabry disease

PL

kryteria LVH w ECG; kardiomiopatia przerostowa; amyloidoza; choroba Fabry’ego

• Publisher: Śląski Uniwersytet Medyczny w Katowicach
• Journal: Annales Academiae Medicae Silesiensis
• Year: 2023
• Issue: 78
• Pages: 173-178

Dates

published

2024

Contributors

author

Mateusz Tometczak

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0009000030429455

author

Judyta Znamirowska

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0009000851030193

author

Justyna Topa

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0009000324290962

author

Patrycja Pastor

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0009000999744520

author

Damian Waksmundzki

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0000000274143771

author

Adam Grzebinoga

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0009000159837564

author

Katarzyna Mizia-Stec

• Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

• https://orcid.org/0000000169072799

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Identifiers

DOI

10.18794/aams/182281

Biblioteka Nauki

40706939