Multimodality Imaging in Patients with Hypertrophic Cardiomyopathy and Atrial Fibrillation

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Ventricular hypertrophy in hypertrophic cardiomyopathy (HCM) is linked to diastolic dysfunction, elevated left atrial (LA) pressure, LA enlargement, fibrosis, and impaired LA function.
• These factors promote left atrial remodeling, increasing the risk and persistence of atrial fibrillation (AF), a common arrhythmia in HCM patients.

Purpose of the Study:

• To review the utility of multimodal imaging in assessing patients with HCM and AF.
• To highlight how imaging can predict new-onset AF and guide treatment and prognosis in HCM patients with AF.

Main Methods:

• Review of existing literature on multimodal imaging techniques in HCM and AF.
• Emphasis on Cardiac Magnetic Resonance (CMR) for its advanced tissue characterization capabilities, overcoming limitations of Transthoracic Echocardiography (TTE).

Main Results:

• Left ventricular hypertrophy and diastolic dysfunction are key drivers of LA remodeling and AF in HCM.
• Multimodal imaging, particularly CMR, provides crucial insights into atrial and ventricular morphology and physiology.

Conclusions:

• Evaluating atrial and ventricular morphology and physiology is vital for managing HCM patients with AF.
• Advanced imaging modalities like CMR are essential for comprehensive assessment, prognosis, and treatment planning in HCM and AF.