Electrocardiographic evolution in patients with hypertrophic cardiomyopathy who develop a left ventricular apical aneurysm

Ermelinda Pennacchini, Maria Beatrice Musumeci, Maria Rosa Conte, Claudia Stöllberger, Francesco Formisano, Sergio Bongioanni, Pietro Francia, Massimo Volpe, Camillo Autore

Research output: Contribution to journalArticlepeer-review


Introduction Hypertrophic cardiomyopathy (HCM) patients with apical aneurysm have a largely unfavourable clinical course, and are often unrecognised because echocardiography is limited in the assessment of the left ventricular (LV) apex. The aim of this study is the identification of electrocardiographic (ECG) abnormalities associated with the development of apical aneurysm in HCM patients. Materials and methods Electrocardiographic features were assessed in 14 HCM patients who had a good-quality baseline ECG recorded before and after the diagnosis of apical aneurysm. Results During follow-up (8.8 ± 7.5 years), the following ECG changes were observed: increase in QRS-complex duration (87 ± 12 ms to 118 ± 34 ms, p = 0.006), QRS-complex fragmentation, decrease in QRS-complex amplitude (SV1 + RV5 -6, from 41 ± 18 mm to 26 ± 11 mm, p = 0.015), ST-segment elevation in V4-V6 (J-point in V5, from - 0.9 ± 1.3 mm to + 0.7 ± 1.3, p = 0.003), positivisation of negative T waves in V3-V6 (T-wave depth in V5, from - 3.4 ± 6.6 to + 3.1 ± 4.1, p = 0.005). Conclusions HCM patients who develop LV apical aneurysm exhibit distinctive ECG changes along with apical remodelling. Suggestive ECGs should lead the physician to study LV apex by nonstandard echocardiographic views, and perform MRI.

Original languageEnglish
Pages (from-to)818-825
Number of pages8
JournalJournal of Electrocardiology
Issue number5
Publication statusPublished - Sep 1 2015


  • Apical aneurysm
  • Electrocardiography
  • Hypertrophic cardiomyopathy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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