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[Morphologic classification of hypertrophic cardiomyopathy with myocardial single photon emission tomography.
G Romero-Farina1, J Candell-Riera, O Pereztol-Valdés
1Servicio de Cardiología. Hospital General Universitari Vall d'Hebron. Barcelona.
Insights
Echocardiogram and single photon emission tomography (SPET) show 75% agreement in classifying hypertrophic cardiomyopathy morphology. Discrepancies were noted, particularly for Type III classifications.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Hypertrophic cardiomyopathy (HCM) presents diverse morphological patterns.
- Accurate classification is crucial for patient management and treatment strategies.
Purpose of the Study:
- To compare the morphological classification of hypertrophic cardiomyopathy (HCM) using echocardiography and single photon emission tomography (SPET).
- To assess the concordance and identify discrepancies between these two imaging modalities in HCM patients.
Main Methods:
- Echocardiography was used to classify 119 HCM patients into six morphological types.
- Two experienced observers independently classified short-axis SPET images (99mTc-tetrofosmin) based on the echocardiographic classification, without knowledge of the echo data.
Main Results:
- A global concordance of 75% was observed between echocardiography and SPET for HCM morphological classification.
- Type III (septal and antero-lateral hypertrophy) was the most frequent type in both modalities but also yielded the most discrepancies.
- SPET identified four cases with predominant septal and inferior hypertrophy not fitting the echocardiographic classification.
Conclusions:
- Echocardiography and SPET demonstrate substantial agreement in classifying HCM morphology.
- Specific discrepancies, especially for Type III, highlight areas for improved diagnostic criteria and interpretation.
Introduction And Objectives:
The aim of this study was to compare different morphologic types of hypertrophic cardiomyopathy obtained by single photon emission tomography to those obtained by echocardiogram.
Materials And Methods:
In 76 (64%) out of 119 patients with hypertrophic cardiomyopathy the echocardiogram permitted an optimal visualization of all left ventricular segments in the short axis view and consequent classification to one of the six morphological types: type I (septal anterior hypertrophy), type II (septal anterior and septal posterior hypertrophy), type III (septal and antero-lateral hypertrophy), type IV (antero-lateral and/or septal posterior hypertrophy), type V (concentric hypertrophy) and type VI (apical hypertrophy). Without knowledge of echo data, two experienced observers included the short axis of single photon emission tomography images at rest (99mTc-tetrofosmin) to one of those types.
Results:
Global concordance between echocardiogram and single photon emission tomography was 75%. Type III was the most frequent both in echo (76%) and in single photon emission tomography (74%) and type III produced the majority of discrepancies. SPET identified 4 patients with a predominant septal and inferior hypertrophy, that did not correspond to any of the 6 types of echocardiographic classification and had been previously classified as type III by echo in 3 cases and as type V in 1 case.
Conclusions:
There was agreement between echo and single photon emission tomography in the morphological classification of most of the patients (75%) with hypertrophic cardiomyopathy. Nevertheless, some discrepancies were observed for the type III echocardiogram.