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Mitral Valve Disease in Hypertrophic Cardiomyopathy:Evaluation and Management

C Charles Jain1, Darrell B Newman1, Jeffrey B Geske2

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

Current Cardiology Reports
|November 2, 2019
PubMed

Insights

The mitral valve (MV) plays a key role in hypertrophic cardiomyopathy (HCM) obstruction. Thorough MV assessment is crucial for HCM patient evaluation and treatment decisions, especially before septal myectomy.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) is often associated with mitral valve (MV) abnormalities.
  • These abnormalities contribute to left ventricular outflow tract (LVOT) obstruction in HCM.
  • Current management strategies for MV abnormalities in HCM remain controversial.

Purpose of the Study:

  • To review the critical role of the MV in HCM pathophysiology.
  • To discuss the evaluation and management of the MV in HCM patients.
  • To examine the impact of MV characteristics on HCM treatment, including septal myectomy.

Main Methods:

  • Review of current literature on mitral valve abnormalities in HCM.
  • Analysis of multimodality imaging techniques for MV assessment in HCM.
  • Discussion of treatment implications based on MV anatomy and function.

Main Results:

  • Multimodality imaging aids in describing MV abnormalities in HCM.
  • Significant controversy exists regarding the optimal management of MV abnormalities.
  • Mitral interventions in HCM patients may be associated with poorer outcomes.
  • Thorough MV assessment is paramount for patient evaluation and treatment planning.

Conclusions:

  • The mitral valve is central to HCM pathophysiology and obstruction.
  • Comprehensive evaluation of MV anatomy and function is essential for all HCM patients.
  • Further research is needed to standardize MV management and compare outcomes across institutions.
Abstract

Keywords:
Hypertrophic cardiomyopathyMitral valveMyectomySystolic anterior motion

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