Patients who have unexplained giant T-wave inversions but do not meet criteria for hypertrophic cardiomyopathy (HCM) (left ventricular (LV) wall thickness < 1.5 cm) demonstrate LV apical morphological features that differ from healthy subjects. Currently, it remains unknown how the abnormal LV apical morphology in this patient population changes over time. The purpose of this study was to investigate LV morphological and functional changes in these patients using a mid-term cardiovascular magnetic resonance (CMR) exam. Seventy-one patients with unexplained giant T-wave inversion who did not fulfill HCM criteria were studied. The mean interval time of the follow-up CMR was 24.4 ± 8.3 months. The LV wall thickness was measured in each LV segment according to the American Heart Association 17-segmented model. The apical angle (ApA) was also measured. A receiver operating curve (ROC) was used to identify the predictive values of the CMR variables. Of 71 patients, 16 (22.5%) progressed to typical apical HCM, while 55 (77.5%) did not progress to HCM criteria. The mean apical wall thickness was significantly different between the two groups at both baseline and follow-up, with the apical HCM group having greater wall thickness at both time points (all p < 0.001). There was a significant difference between the two groups in the change of ApA (− 1.5 ± 2.7°/yr vs. − 0.7 ± 2.0°/yr, p < 0.001) over time. The combination of mean apical wall thickness and ApA proved to be the best predictor for fulfilling criteria for apical HCM with a threshold value of 8.1 mm and 90° (sensitivity 93.8%, specificity 85.5%). CMR metrics identify predictors for progression to HCM in patients with unexplained giant T-wave inversion.

中文翻译：

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不符合肥厚型心肌病标准但存在不明原因巨大 T 波倒置的患者：一项心血管磁共振中期随访研究

有不明原因的巨大 T 波倒置但不符合肥厚型心肌病 (HCM) 标准（左心室 (LV) 壁厚 < 1.5 cm）的患者表现出与健康受试者不同的 LV 心尖形态特征。目前，该患者群体中异常的 LV 心尖形态如何随时间变化仍然未知。本研究的目的是使用中期心血管磁共振 (CMR) 检查来调查这些患者的 LV 形态和功能变化。研究了 71 名不符合 HCM 标准的不明原因巨大 T 波倒置患者。随访 CMR 的平均间隔时间为 24.4 ± 8.3 个月。根据美国心脏协会 17 节段模型测量每个 LV 节段的 LV 壁厚。还测量了顶角(ApA)。受试者工作曲线 (ROC) 用于确定 CMR 变量的预测值。在 71 名患者中，16 名 (22.5%) 进展为典型的根尖 HCM，而 55 名 (77.5%) 未进展到 HCM 标准。两组在基线和随访时的平均心尖壁厚度显着不同，心尖 HCM 组在两个时间点的壁厚都更大（所有 p < 0.001）。两组之间的 ApA 随时间的变化存在显着差异（- 1.5 ± 2.7°/yr vs. - 0.7 ± 2.0°/yr，p < 0.001）。平均根尖壁厚和 ApA 的组合被证明是满足根尖 HCM 标准的最佳预测指标，阈值为 8.1 mm 和 90°（灵敏度 93.8%，特异性 85.5%）。