Figure 1

A representative patient with hypertension and ApHCM. (A) The 12-lead resting electrocardiogram shows left ventricular hypertrophy with a giant negative T-wave in the V_2–4 leads. Parasternal long-axis echocardiographic images show apical hypertrophy (double arrowheads) at the end-diastolic phase (B) and apical obstruction (arrow) at the end-systolic phase (C). Representative examples of global longitudinal strain (GLS) images in hypertensive patients with ApHCM (D, GLS = −17.3%) and without ApHCM (E, GLS = −18.3%). The GLS decreases without a base-to-apex gradient in hypertensive patients with ApHCM as compared with hypertensive patients without ApHCM.