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Comparison of Nonclassic and Classic Phenotype of Hypertrophic Cardiomyopathy Focused on Prognostic Cardiac Magnetic

Magdalena Stachera1, Paweł Przybyło2, Katarzyna Sznajder1

  • 1Clinical Department of Diagnostic Imaging, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland.

Diagnostics (Basel, Switzerland)
|May 28, 2022
PubMed

Insights

Nonclassic hypertrophic cardiomyopathy (HCM) patients show distinct cardiac magnetic resonance (CMR) findings compared to classic HCM. These differences in advanced HCM markers may aid future risk stratification and understanding of disease progression.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Nonclassic phenotypes (NCP) represent advanced hypertrophic cardiomyopathy (HCM) and are challenging to diagnose and manage.
  • NCP are often underrepresented in research, necessitating further investigation into their unique characteristics.

Purpose of the Study:

  • To compare cardiac magnetic resonance (CMR) parameters between nonclassic phenotypes (NCP) and classic phenotypes (CP) of HCM.
  • To identify established and potential prognostic indicators in NCP versus CP using standard and non-standard CMR variables.

Main Methods:

  • Retrospective analysis of CMR studies from 88 patients diagnosed with HCM between 2011 and 2019.
  • Postprocessing of CMR data to obtain standard and non-standard parameters, focusing on left ventricular and atrial function, and tissue characterization.

Main Results:

  • NCP exhibited higher late gadolinium enhancement extent (%LGE) and left ventricular mass index (LVMI), lower left atrium emptying fraction (LAEF), greater minimal left atrial volume (LAV min), and reduced myocardial contraction fraction (MCF) and left ventricular global function index (LVGFI) compared to CP.
  • No left ventricular outflow tract obstruction (LVOTO) was found in NCP. Significant differences in left ventricular outflow tract (LVOT) and aortic valve (Ao) dimensions were observed.
  • HCM risk score and left ventricular maximal thickness (LVMT) were similar between NCP and CP groups.

Conclusions:

  • Significant differences in non-standard CMR parameters distinguish NCP from CP in hypertrophic cardiomyopathy.
  • These findings may inform future research on disease staging and risk stratification in advanced HCM phenotypes.

Keywords:
functional imaginghypertrophic cardiomyopathylate gadolinium enhancementleft atriumleft ventricular obstructionmagnetic resonance imagingmitral valve apparatusnew imaging techniquesoutcomesphenotypeprognosissudden cardiac death

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