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Assessment of Cardiac Morphological and Functional Changes in Mouse Model of Transverse Aortic Constriction by Echocardiographic Imaging
Published on: June 21, 2016
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.
Abstract:
Treatments for hypertrophic cardiomyopathy are largely selected based on patient symptoms and echocardiographic findings. Moreover, all the advanced treatments for heart failure symptoms depend on such imaging for planning and monitoring response to therapy. Risk of sudden death correlates with maximum left ventricular (LV) wall thickness. Massive LV thickening of 30 mm or more is an indication for primary prevention of sudden death with an implanted defibrillator. In this review, we will underscore potential pitfalls in echocardiographic diagnosis. Also we will review, a newly appreciated pathophysiologic mechanism in obstruction dynamic systolic dysfunction due to gradient.
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