[Echocardiographic study of hypertrophic myocardiopathy in children. Distribution and changing morphological course]

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Cardiovascular Imaging

Background:

• Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition affecting children.
• Understanding the diverse presentations of pediatric HCM is crucial for diagnosis and management.
• Echocardiography is a key tool for evaluating cardiac structure and function in pediatric patients.

Purpose of the Study:

• To categorize pediatric patients with hypertrophic cardiomyopathy using echocardiographic findings.
• To investigate the relationship between age, morphologic myocardial affection, and clinical presentation in pediatric HCM.
• To differentiate true myocardiopathies from secondary hypertrophies in young children.

Main Methods:

• Analysis of 38 children diagnosed with hypertrophic cardiomyopathy.
• Utilized M-Mode, two-dimensional, and Doppler echocardiography.
• Patients were stratified into three groups based on age and echocardiographic morphology: biventricular involvement (group 1), left ventricular concentric hypertrophy (group 2), and localized mid-ventricular hypertrophy (group 3).

Main Results:

• Three distinct echocardiographic groups were identified based on age and myocardial affection.
• Obstruction was detected in 46.8% of cases, with higher frequency in the oldest group (group 3).
• Systolic anterior motion of the mitral valve and mitral regurgitation were most frequent in group 3.
• The youngest group (group 1) exhibited significant variability, with one-third improving and one-third mortality.

Conclusions:

• Echocardiography effectively classifies pediatric hypertrophic cardiomyopathy into three age- and anatomy-based groups.
• The variable outcomes in the youngest group suggest potential secondary myocardial hypertrophies.
• Classic adult HCM parameters were primarily observed in the oldest pediatric group.