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Master Thesis

L’électrocardiogramme : un outil diagnostique et pronostique dans la cardiomyopathie hypertrophique

Abstract : Background: in hypertrophic cardiomyopathy (HCM), the electrocardiogram (ECG) is mainly used as a screening tool. Objective: the objective of our study was to demonstrate other ECG utilities by studying the classification of different HCM and the prediction of cardiovascular events. Methods: we conducted a retrospective multicenter study involving patients from the HCM Clinical Research Observatory (REMY). Based on the ECG criteria, we analyzed the differences between sarcomeric forms of HCM, Fabry disease and cardiac amyloidosis, as well as the prognostic factors of syncope, hospitalization and rhythm disorders in this population. Results: we included 490 patients including 70 with a sarcomeric mutation, 19 with cardiac amyloidosis and 11 with Fabry disease. Our results show that the presence of atrio-ventricular block type 1 was associated with amyloidosis (p = 0.038), the right branch block with non-sarcomeric forms (p = 0.005) and the left axis with sarcomeric mutation ( p = 0.03). In the predictive factors, the duration of the QRS ³ 120 ms was significantly correlated with the occurrence of hospitalizations for cardiovascular reasons (OR = 2.03, IC 1.1-4, p = 0.02), the Q wave for ventricular rhythm disorders (OR=1.8 ; IC1.06– 3.07 ; p=0.035), the duration of the P wave for atrial rhythm disorders (OR = 1.05, IC1.03 -1.12, p = 0.002), and intra-ventricular conduction disorders undifferentiated for syncopes (OR = 2.27, IC 1.06-4.86, p = 0.033). Conclusion: some ECG criteria appear to correlate with specific etiologies of CMH and their complications.
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Master Thesis
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Submitted on : Friday, March 23, 2018 - 11:09:27 AM
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Louis Larnier. L’électrocardiogramme : un outil diagnostique et pronostique dans la cardiomyopathie hypertrophique . Médecine humaine et pathologie. 2017. ⟨dumas-01741527⟩

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