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Apical hypertrophic cardiomyopathy: potential utility of Strain imaging
Madhulatha Reddy1, Deepak Thatai, Juan Bernal
1Division of Cardiology, Wayne State University, Harper University Hospital, Detroit Medical Center, Detroit MI 48201, USA.
Insights
Diagnosing apical hypertrophic cardiomyopathy (HCM) can be challenging. Two-dimensional (2D) strain imaging revealed paradoxical systolic lengthening in the apex, aiding diagnosis in two patients.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Hypertrophic cardiomyopathy (HCM) is commonly diagnosed via echocardiography.
- The apical variant of HCM, also known as the 'Japanese variant,' is rare and diagnostically challenging.
- Novel imaging techniques like strain imaging are increasing interest in HCM diagnosis.
Purpose of the Study:
- To investigate the utility of 2D strain imaging in diagnosing apical HCM.
- To describe a novel finding of paradoxical apical strain in apical HCM patients.
Main Methods:
- Utilized two-dimensional (2D) strain echocardiography.
- Analyzed tissue velocities through frame-to-frame tracking of acoustic markers.
- Assessed strain parameters, comparing them to tissue-Doppler-derived strain.
Main Results:
- Observed paradoxical apical strain (systolic lengthening) in two patients with apical HCM.
- This finding was present without overt apical dyskinesis on conventional imaging.
- 2D strain imaging provided a novel diagnostic marker.
Conclusions:
- Two-dimensional strain imaging offers a valuable tool for diagnosing apical HCM.
- Paradoxical apical strain is a potential indicator for this rare HCM variant.
- This technique can facilitate earlier and more accurate diagnosis of apical HCM.
Abstract:
Hypertrophic cardiomyopathy (HCM) is a frequently recognized condition on echocardiography. The apical variant, also known as 'Japanese variant', is rare and often poses a diagnostic challenge. There has been a resurgence of interest in the diagnosis of HCM especially with the advent of novel imaging modalities such as strain imaging. Two-dimensional (2D) strain echocardiography calculates tissue velocities via frame-to-frame tracking of acoustic markers within the image and provides strain parameters comparable with tissue-Doppler-derived strain. We describe paradoxical apical strain (systolic lengthening) without overt apical dyskinesis (conventional imaging) in two patients with apical HCM, using 2D strain imaging. Our report highlights a novel application of 2D strain imaging that could facilitate the diagnosis of apical HCM.
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