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Advances in Multi-Modality Imaging in Hypertrophic Cardiomyopathy
Fraser C Goldie1, Matthew M Y Lee1, Caroline J Coats1,2
1School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK.
Insights
Hypertrophic cardiomyopathy (HCM) diagnosis relies on multi-modality imaging. This review details electrocardiography, echocardiography, cardiac magnetic resonance, CT, and nuclear imaging roles in HCM patient care and research.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Hypertrophic cardiomyopathy (HCM) involves abnormal myocardial growth, myofilament disarray, and hyper-contractility, leading to left ventricular hypertrophy and fibrosis.
- Genetic factors related to cardiomyocyte sarcomere structure and function are often implicated in HCM.
Purpose of the Study:
- To review the roles of various imaging modalities in the diagnosis, monitoring, and risk stratification of HCM.
- To discuss the strengths and limitations of electrocardiography, echocardiography, cardiac magnetic resonance (CMR), cardiac computed tomography (CT), and nuclear imaging in HCM management.
Main Methods:
- Review of current literature and guidelines, focusing on established and emerging imaging techniques for HCM.
- Analysis of multi-modality imaging approaches, including their combined use for personalized patient care.
Main Results:
- Each imaging modality (ECG, echocardiography, CMR, CT, nuclear imaging) offers unique insights into HCM.
- Combining imaging techniques can enhance diagnostic accuracy, risk stratification, and treatment planning for HCM patients.
Conclusions:
- Multi-modality imaging is essential for comprehensive HCM management, from diagnosis to risk assessment.
- Integrating various imaging modalities supports personalized patient care and advances research in HCM.
Abstract:
Hypertrophic cardiomyopathy (HCM) is characterized by abnormal growth of the myocardium with myofilament disarray and myocardial hyper-contractility, leading to left ventricular hypertrophy and fibrosis. Where culprit genes are identified, they typically relate to cardiomyocyte sarcomere structure and function. Multi-modality imaging plays a crucial role in the diagnosis, monitoring, and risk stratification of HCM, as well as in screening those at risk. Following the recent publication of the first European Society of Cardiology (ESC) cardiomyopathy guidelines, we build on previous reviews and explore the roles of electrocardiography, echocardiography, cardiac magnetic resonance (CMR), cardiac computed tomography (CT), and nuclear imaging. We examine each modality's strengths along with their limitations in turn, and discuss how they can be used in isolation, or in combination, to facilitate a personalized approach to patient care, as well as providing key information and robust safety and efficacy evidence within new areas of research.
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