الفهرس 
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Abstract
Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease that is inherited mainly in an autosomal dominant pattern and characterized by asymmetric LVH that can‟t be explained solely by abnormal loading conditions.
Several clinical presentations were observed in HCM patients including dyspnea, angina, palpitation and syncope. On the other hand, many patients may remain asymptomatic along the course of the disease or sudden cardiac death may be the first presentation which is a catastrophic event.
Analysis of the ECGs of HCM patients revealed several abnormalities including ECG evidence of LVH, repolarization abnormalities, atrial abnormalities, atrial and ventricular arrhythmias and conduction system abnormalities.
Aim of the study
Studying the left ventricular mechanical changes associated with conduction blocks in HCM patients and its relation to the cardiac phenotype.
Methods and results
We analyzed the data derived from the ECG, conventional echocardiography, TDI and 2-D STE in 53 HCM patients with conduction blocks on surface ECG, 44 HCM without conduction blocks and 33 control subjects and followed both HCM groups for 6 years to determine the clinical impact of these conduction blocks on HCM patients.
We found that HCM patients with conduction blocks have more severe phenotype (higher values of LVM, LVMI, MWT, SWT and S/P ratio in addition to higher incidence of SAM), more severe impairment in diastolic function (lower values of E and A waves velocities, higher values of E/E´ and
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Summ ary and conclusion
more dilated LA) and more severe intraventricular dyssynchrony (higher values of TTP-d and TTP-SD).
Regression analysis of the studied variables showed that the functional class correlated directly to QTc dispersion and inversely to ɛsys and that E/E´ correlated directly to both QRS duration and QTc dispersion. A direct correlation was also detected between QRS duration and TTP-d.
By following both HCM groups, we found that the incidence of hospitalization was higher in the conduction blocks group, however, there was no statistically significant difference in mortality between both groups.