Electrocardiographic predictors of myocardial fibrosis and apical hypertrophic cardiomyopathy

Background Electrocardiography (ECG) may be an efficacious diagnostic and prognostic tool in hypertrophic cardiomyopathy (HCM). This study aimed to investigate association between deep T‐wave inversion (TWI) and apical HCM, and between fragmented QRS (fQRS) complex and myocardial fibrosis in patients with HCM. Methods Patients with documented HCM by cardiac magnetic resonance imaging (CMR) during 2005–2015 were studied. The 12‐lead ECG and CMR were performed on the same day. All patients underwent CMR for the assessment of cardiac structure, function, and late gadolinium enhancement (LGE). LGE was used to detect myocardial fibrosis. Results One hundred forty‐four HCM (mean age 66 ± 15.8 years, 60.4% male) were included. Twenty‐nine (20.14%) subjects had deep TWI, and apical HCM was found in 76 (52.78%). Deep TWI was associated with apical HCM with the Odds ratio (95%CI) of 5.82 (2.07, 16.04) and p