Echocardiography to individualize treatment for hypertrophic cardiomyopathy

Mark V Sherrid1, Milla Arabadjian

  • 1Division of Cardiology, St Luke's-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, 1000 10th Ave, New York City, NY 10019, USA. msherrid@chpnet.org

Insights

Echocardiography guides hypertrophic cardiomyopathy treatment, but pitfalls exist. This review highlights diagnostic challenges and a new mechanism of dynamic systolic dysfunction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Pathophysiology

Background:

  • Hypertrophic cardiomyopathy (HCM) treatment relies on echocardiography for symptom assessment and therapy monitoring.
  • Left ventricular (LV) wall thickness on echocardiography correlates with sudden cardiac death risk.
  • LV thickness ≥30 mm warrants defibrillator implantation for primary prevention.

Purpose of the Study:

  • To review potential diagnostic pitfalls in echocardiography for HCM.
  • To discuss a newly understood pathophysiologic mechanism in dynamic systolic dysfunction causing obstruction.

Main Methods:

  • Literature review of echocardiographic diagnostic criteria in HCM.
  • Review of current understanding of HCM pathophysiology, focusing on dynamic obstruction.

Main Results:

  • Echocardiography, while crucial, may present diagnostic challenges in HCM.
  • Dynamic systolic dysfunction due to gradients is an emerging mechanism affecting obstruction.

Conclusions:

  • Accurate echocardiographic diagnosis is vital for effective HCM management.
  • Understanding novel pathophysiologic mechanisms improves therapeutic strategies and patient outcomes in HCM.

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