Author + information
- Received February 3, 1995
- Revision received July 11, 1995
- Accepted July 20, 1995
- Published online December 1, 1995.
- Yoshinori Koga, MDa,*,
- Atsushi Katoh, MDa,
- Komei Matsuyama, MDa,
- Hisao Ikeda, MDa,
- Kohji Hiyamuta, MDa,
- Hironori Toshima, MD* and
- Tsutomu Imaizumi, MD, FACCa
- ↵*Address for correspondence: Dr. Yoshinori Koga, The Third Department of Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume 830, Japan.
Objectives. The present study investigated the long-term changes in the electrocardiographic (ECG) hallmarks of the Japanese form of apical hypertrophy.
Background. Giant negative T waves and tall R waves in the left precordial leads are the ECG hallmarks of the Japanese form of apical hypertrophy. However, the long-term course is largely unknown.
Methods. Twenty-nine patients with apical hypertrophy (26 men, 3 women, mean age ± SD 50.4 ± 8.2 years) who showed left precordial giant negative T waves (≤−10 mm) and tall R waves (≥26 mm) and spade configuration in the left ventriculogram were followed up for 10.9 ± 3.7 years.
Results. The intermediate follow-up ECGs (5 to 9 years) showed disappearance of giant negative T waves in 31% and of tall R waves in lead V5in 6%. At the long-term follow-up study (≥10 years), loss of giant negative T waves increased to 71%, with average T wave negativity in lead V4or V5decreasing from −16.5 ± 5.1 to −6.9 ± 4.2 mm. These T wave changes were associated with decreases in R wave amplitude in lead V5from 40.7 ± 9.6 to 26.1 ± 13.8 mm, with loss of tall R waves in lead V5in 38% of patients and development of abnormal Q waves in two patients.
Conclusions. During the long-term follow-up of the Japanese form of apical hypertrophy, giant negative T waves disappeared in association with decreases in R wave amplitude in lead V5, indicating that these ECG hallmarks are clinical features that evolve progressively during the natural course of the disease.
This study was supported in part by a research grant for intractable diseases from the Ministry of Health and Welfare of Japan, Tokyo, Japan.
- Received February 3, 1995.
- Revision received July 11, 1995.
- Accepted July 20, 1995.
- American College of Cardiology