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The Role of the Submitral Apparatus in Hypertrophic Obstructive Cardiomyopathy

Jia Tao1, Fujian Duan2, Jili Long1

  • 1Department of Echocardiography, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|October 3, 2022
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) can cause left ventricular outflow tract obstruction (LVOTO). This review highlights the critical role of the submitral apparatus in HCM-related LVOTO mechanisms.

Area of Science:

  • Cardiology
  • Genetics
  • Pathophysiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a prevalent genetic cardiovascular disease affecting 0.2-0.5% of the population.
  • Left ventricular outflow tract obstruction (LVOTO) is a serious phenotype of HCM, linked to increased morbidity and mortality.
  • Factors like septal hypertrophy and mitral valve abnormalities contribute to LVOTO.

Purpose of the Study:

  • To review recent advancements in understanding the submitral apparatus.
  • To elucidate the submitral apparatus's role in systolic anterior motion (SAM) and LVOTO in HCM patients.

Main Methods:

  • Literature review of recent studies on hypertrophic cardiomyopathy.
  • Analysis of the anatomical and functional contributions of the mitral valve and submitral apparatus.

Main Results:

  • The mitral valve's role in SAM and LVOTO is well-established.
  • Emerging evidence emphasizes the submitral apparatus as a key factor in LVOTO development.
  • Understanding submitral apparatus mechanics is crucial for predicting and managing LVOTO in HCM.

Conclusions:

  • The submitral apparatus is a significant contributor to LVOTO in hypertrophic cardiomyopathy.
  • Further research into the submitral apparatus can improve therapeutic strategies for HCM patients with LVOTO.

Keywords:
Hypertrophic cardiomyopathyLeft ventricular outflow tract obstructionSubmitral apparatus

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