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Helical distribution of hypertrophy in patients with hypertrophic cardiomyopathy: prevalence and clinical

Dafne Viliani1, Eduardo Pozo1, Norma Aguirre1

  • 1Cardiology Department, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle Diego de León, 62, 28006, Madrid, Spain.

The International Journal of Cardiovascular Imaging
|May 25, 2017
PubMed

Insights

A helical pattern of hypertrophy is common in hypertrophic cardiomyopathy (HCM) and linked to worse outcomes. This pattern, assessed via cardiac magnetic resonance (CMR), indicates a higher risk of sudden cardiac death (SCD).

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Medical Diagnostics

Background:

  • A novel helical distribution pattern of hypertrophy has been recently described in hypertrophic cardiomyopathy (HCM) patients.
  • The prevalence and clinical significance of this helical pattern in an unselected HCM cohort require further investigation.

Purpose of the Study:

  • To determine the prevalence of the helical hypertrophy pattern in a cohort of hypertrophic cardiomyopathy patients.
  • To assess the potential clinical implications and associations of this helical pattern with adverse cardiovascular events.

Main Methods:

  • One hundred and eight consecutive patients diagnosed with HCM via cardiac magnetic resonance (CMR) were included.
  • Helical pattern presence was assessed by measuring maximal left ventricle (LV) wall thickness in 17 LV segments.
  • Clinical data and follow-up information were prospectively collected for analysis.

Main Results:

  • A helical distribution pattern was detected in 58% of HCM patients.
  • This pattern was significantly associated with increased left ventricular outflow tract obstruction (LVOT), non-sustained ventricular tachycardia (NSVT), and a higher estimated risk of sudden cardiac death (SCD).
  • Patients with more extensive helical patterns showed higher incidences of heart failure and all-cause death.

Conclusions:

  • A helical pattern of hypertrophy is a frequent finding in hypertrophic cardiomyopathy and can be readily assessed using standard CMR cine sequences.
  • The presence of a helical pattern is associated with significant negative clinical implications, including an elevated risk of sudden cardiac death.
  • This finding underscores the importance of recognizing and evaluating helical hypertrophy patterns in HCM management.

Keywords:
Cardiac magnetic resonanceHelical patternHypertrophic cardiomyopathyLeft ventricular hypertrophyPrognosisSudden cardiac death

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