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Abstract
BackgroundHypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. The aim of this study was to evaluate the utility of three-dimensional echocardiography (3DE) for the geometric assessment of LV hypertrophy and PM morphology.MethodsThe study included 24 patients with an established diagnosis of HC and 31 healthy controls. 3DE was performed using an iE33 or EPIQ 7C ultrasound system with an X5-1 transducer. QLAB software was used for the 3D analysis of LV wall thickness (LVWT) and PM morphology and hypertrophy; the number and cross-sectional area (CSA) of anterolateral and posteromedial PMs; and the presence of bifid or accessory PMs.ResultsPatients with HC had a larger LVWT compared to controls in all segments (p < 0.001), and LVWT was largest in the midventricular septal segment (2.12 ± 0.68 cm). The maximum LVWT followed a spiral pattern from the LV base to the apex. The CSA of both anterolateral and posteromedial PMs was larger in patients with HC than in controls (1.92 vs. 1.15 cm2; p = 0.001 and 1.46 vs. 1.08 cm2; p = 0.033, respectively). The CSA of the posteromedial PM was larger in patients with LVOT obstruction than in those without (2.64 vs 1.16 cm2, p = 0.021).Conclusions3DE allows the assessment of LV geometry and PM abnormalities in patients with HC. 3DE demonstrated that the maximum hypertrophy was variable and generally located in a spiral from the LV base to the apex.
Highlights
Hypertrophic cardiomyopathy (HC) is the most common inherited cardiac disease, with an estimated prevalence of 1 in 500 [1]
This study demonstrates the utility of 3DE for the assessment of the geometric pattern of left ventricular (LV) hypertrophy and papillary muscle (PM) morphology in patients with HC
Maximal LV hypertrophy was present at basal level in the infero- and anteroseptal segments, at midventricular level in the anteroseptal segments, and at apical level in the lateral segments
Summary
Hypertrophic cardiomyopathy (HC) is the most common inherited cardiac disease, with an estimated prevalence of 1 in 500 [1]. Hypertrophic cardiomyopathy is characterized by a broad clinical and morphological spectrum including left ventricular (LV) hypertrophy and abnormal LV papillary muscle (PM) morphology and thickness [2,3,4,5,6,7]. The aim of this study was to assess the utility of 3DE for the assessment of LV geometry and PM abnormalities in patients with HC as compared to healthy controls. Hypertrophic cardiomyopathy (HC) is characterized by left ventricular (LV) hypertrophy and associated with papillary muscle (PM) abnormalities. The aim of this study was to evaluate the utility of three-dimensional echocardiography (3DE) for the geometric assessment of LV hypertrophy and PM morphology. Conclusions 3DE allows the assessment of LV geometry and PM abnormalities in patients with HC. 3DE demonstrated that the maximum hypertrophy was variable and generally located in a spiral from the LV base to the apex
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