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Phenotypic spectrum and clinical characteristics of apical hypertrophic cardiomyopathy: multicenter echo-Doppler

Eui-Young Choi1, Se-Joong Rim, Jong-Won Ha

  • 1Yonsei University College of Medicine, Seoul, Republic of Korea.

Cardiology
|October 16, 2007
PubMed

Insights

Apical hypertrophic cardiomyopathy (ApHCM) presents three distinct subtypes: pure focal, pure diffuse, and mixed. Subtyping ApHCM is crucial for predicting atrial fibrillation risk and assessing left ventricular function.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Genetics

Background:

  • Apical hypertrophic cardiomyopathy (ApHCM) is a variant of hypertrophic cardiomyopathy characterized by hypertrophy predominantly affecting the apex of the left ventricle.
  • Understanding the phenotypic spectrum and clinical implications of ApHCM subtypes is essential for patient management and risk stratification.

Purpose of the Study:

  • To define the phenotypic spectrum of apical hypertrophic cardiomyopathy (ApHCM).
  • To identify clinical characteristics associated with different ApHCM subtypes.
  • To investigate the predictive value of ApHCM subtyping for clinical outcomes.

Main Methods:

  • 182 consecutive ApHCM patients with preserved ejection fraction (>50%) were analyzed.
  • Left ventricular end-diastolic wall thickness was measured in all 16 segments to classify hypertrophy patterns.
  • Echo-Doppler parameters, electrocardiography, and clinical findings were assessed to correlate with hypertrophy subtypes.

Main Results:

  • Three ApHCM subtypes were identified: pure focal (n=81), pure diffuse (n=70), and mixed (n=31).
  • Significant differences were observed in atrial fibrillation incidence (5% vs. 11% vs. 23%, p<0.05) and left atrial volume index (30.9 vs. 35.7 vs. 41.3 ml/m², p<0.001) among subtypes.
  • Subtypes also showed significant variations in peak systolic and diastolic mitral annular velocities and E/E' ratios (p<0.05).

Conclusions:

  • ApHCM encompasses three morphologically distinct phenotypes.
  • Detailed subtyping of ApHCM is important for predicting atrial fibrillation development.
  • Subtyping aids in assessing left atrial volume index and left ventricular longitudinal function.
Abstract

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