الفهرس 
Ch. (1): Hypertrophic CardiomyopathyOnly 14 pages are availabe for public view
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Abstract
The aim of this study is to investigate electrocardiographic changes and
findings in 24 hours Holter monitoring in Hypertrophic Cardiomyopathy
patients and their relation to cardiovascular morbidity and mortality.
Methods:
This study will include patients diagnosed with Hypertrophic
Cardiomyopathy according to AHA. & ESC. guidelines, they will be recruited
from Yacoub research unit in Menoufia University Hospital and will be
followed up for more than one year regarding their cardiovascular morbidity
and mortality.
All the patients will be subjected to the following:
Detailed clinical history, Comprehensive physical examination. Conventional
echocardiography, Resting 12 leads ECG. Ambulatory 24 hs holter ECG.
Longitudinal follow up for more than one year.
Results
There is statistically significant negative correlation between SDNN
which represent overall heart rate variability (HRV) and LVPW and rest LVOT.
PG ( p=.01),( p=.05).
There is statistically significant negative correlation between NN50 which
represent short term component of (HRV) and LVPW and LVM. (p=.01),(
p=.04),
There is statistically significant positive correlation between IVCD in ECG
at cut off point of QRS duration >110 msec and septal thickness, MWT., rest
LVOTpg). (p=.05 ), ( p=.03), (p=.00 )
Summary
111
There is statistically significant positive correlation between LVPWT and
R wave voltage in lead V5 and V6 (p=.00). (p= .01).
There is statistically significant positive correlation between presence of
LVH by sokolow Lyon criteria R wave voltage in V5 or V6 ≥35 mm and
(LVPWT, LVM,) P values are (p=.01)( p=.00)
significant positive correlation between presence of LVH by sokolow Lyon
criteria R wave voltage in aVL lead in ECG ˃11 mm and LVM P value p=.04
Positive correlation between shortest QT and (LVPWT, LVM, rest
LVOTPG) (p=.00),( p=.00) (p=.00).
positive correlation was found between longest QTc and(LVPW, LVM,
rest LVOTpg) P values are (p=.01)( p=.007)( p=.03).
There is statistically significant positive correlation between presence of
inverted T wave in ECG and presence of symptoms and presence of SAM
(p=.00). (p=.00). This means that inverted T wave in resting ECG is an
electrocardiographic predictor of morbidity in HCM patients.
There is statistically significant positive direct correlation between
presence of ventricular tachycardia in 24 hours Holter monitoring and mortality
rate (P < 0.001) , This means that ventricular tachycardia in 24 hours Holter
monitoring is an electrocardiographic predictor of mortality in HCM patients.
There is statistically significant difference between survivors and non
survivors in ECG parameters which are P duration (P value = 0.001), P-R
duration (P value = 0.011), Shortest QTc (P value = 0.036), S V2 in mm (P
value = 0.038).
There was statistically significant correlation between some parameters in
ECG and morbidity and the Need for hospitalization. These parameters are:
shortest QTc, corrected QTcd.
Summary
112
There was statistically significant correlation between some parameters in
24 hours Holter monitoring and morbidity and the Need for hospitalization
these parameters are: SDNN, SDANN
There is statistically significant positive correlation between SDNN<50
(low HRV) and (pulse pressure, LVPW thickness and LV mass) P value ( .04,
.001 and <.001)
Conclusion:
Each HCM patient has a survival probability of 93+/- 2.5% at 10 years.
And this is nearly normal life expectancy contrary to the traditional concept
about HCM patients. The LVM was Independent Predictor for Morbidity and
need of hospitalization. Increase in LVM more pronounced in LVPW in HCM
patients is predictor of decrease in heart rate variability. Increase in QTc than
normal in HCM patients increases the probability of mortality
inverted T wave in resting ECG is an electrocardiographic predictor of
morbidity in HCM patients. ventricular tachycardia in 24 hours Holter
monitoring is an electrocardiographic predictor of mortality in HCM patients .
Low heart rate variability is a predictor of morbidity in HCM patients.