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Apical hypertrophic cardiomyopathy: correlations between echocardiographic parameters, angiographic left ventricular

Chao-Chin Chen1, Meng-Huan Lei, Yu-Cheng Hsu

  • 1Division of Cardiology, Department of Medicine, Lo-Tung Poh-Ai Hospital, I-Lan, Taiwan. chen.stpaul@msa.hinet.net

Clinical Cardiology
|March 15, 2011
PubMed

Insights

Echocardiography can identify specific features of apical hypertrophic cardiomyopathy (ApHCM) linked to worse outcomes. Detecting cavity obliteration and paradoxical flow helps predict cardiovascular events in ApHCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Apical hypertrophic cardiomyopathy (ApHCM) can lead to apical asynergy, including sequestration or aneurysm.
  • These echocardiographic findings may correlate with adverse cardiovascular outcomes.

Purpose of the Study:

  • To investigate the association between echocardiographic parameters and morphological patterns of left ventriculograms with cardiovascular morbidity and mortality in ApHCM patients.

Main Methods:

  • A cohort of 47 ApHCM patients was followed for 35.4 months.
  • Echocardiographic measurements included hypertrophy extent/degree, cavity obliteration, and paradoxical diastolic jet flow.
  • Left ventriculograms were analyzed for morphological abnormalities; cardiac catheterization was performed when consent was obtained.

Main Results:

  • Of 47 patients, 30 had pure ApHCM and 17 had mixed ApHCM. Sustained cavity obliteration was observed in 28 patients, with 17 showing paradoxical flow.
  • Left ventriculograms revealed "ace-of-spades" (15/31), apical sequestration (12/31), and apical aneurysm (4/31).
  • Cardiovascular morbidities (21/47 patients) were linked to mixed ApHCM, cavity obliteration, and paradoxical flow. Three of four deaths were associated with apical aneurysm.

Conclusions:

  • Echocardiography is crucial for detecting cavity obliteration and paradoxical flow in ApHCM.
  • Differentiating pure from mixed ApHCM forms and identifying apical sequestration versus aneurysm via echocardiography is clinically important.
Abstract

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