ABC | Volume 110, Nº1, January 2018

Original Article Paixão et al Correlation of ECG with RM in hypertrophic cardiomyopathy Arq Bras Cardiol. 2018; 110(1):52-59 Figure 2 – A) E.D.S., male sex, 35 years. ECG: R wave in D1 of 35 mm, and R wave in V5 of 29 mm. Magnetic resonance imaging compatible with concentric hypertrophy. Fibrosis mass of 128 g (greatest fibrosis mass found of all patients analyzed). B) M.L.S.F., female sex, 60 years. ECG: R wave in D1 of 23 mm, and R wave in V5 of 22 mm. Magnetic resonance imaging compatible with septal hypertrophy. C) P.M., male sex, 77 years. ECG: R wave of 35 mm in V5, and negative T wave of 12 mm with strain pattern. Magnetic resonance imaging compatible with apical hypertrophy. Results This study assessed 70 patients, 55.9% of the female sex, with a mean age of 51.3 years (ranging from 20 to 81 years). Of the six location patterns of hypertrophy, only three were found: apical (10%), concentric (21%) and septal (69%). (Figure 3) Most patients (81.4%) showed delayed enhancement on magnetic resonance imaging, and all patients with concentric hypertrophy had fibrosis. In quantifying the mass of fibrosis according to the location of hypertrophy, the highest mean (57.1 g) was observed in concentric hypertrophy as compared to the other locations (p = 0.001). (Table 1, Figure 4) The concomitant presence of right ventricular hypertrophy on magnetic resonance imaging was found in 35.7% of the patients with concentric hypertrophy, showing statistical significance (p = 0.0447) as compared to septal and apical hypertrophies. Patients with apical hypertrophy more frequently had atrial fibrillation (14.3%), preserved heart axis being identified in 100% of the cases. Such findings, however, had no statistical significance (p = 0.7964, p = 0.6730, respectively). Regarding ventricular overloads, there was higher prevalence of both left and right ventricular overloads (71.4% and 21.4%, respectively) in concentric hypertrophy, with no statistical significance (p = 0.1883, p = 0.2117, respectively). The strain pattern showed statistical significance between the types of hypertrophy (p < 0.0001), being present in 100% of the apical hypertrophy cases and in 71.4% of the concentric hypertrophy cases. 54