Multimodality Imaging in Apical Hypertrophic Cardiomyopathy: Can Echocardiography Learn from Cardiac Magnetic...

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Apical hypertrophic cardiomyopathy (AHC) is an under-recognized variant of hypertrophic cardiomyopathy.
• It is characterized by predominant thickening of the left ventricle's apical segments.

Purpose of the Study:

• To review the diagnostic roles and complementary nature of echocardiography and cardiac magnetic resonance imaging (CMR) in AHC.
• To highlight how CMR can refine echocardiographic practice for AHC diagnosis.

Main Methods:

• Review of echocardiography and CMR in diagnosing and assessing apical hypertrophic cardiomyopathy.
• Comparison of the strengths and limitations of each imaging modality for AHC.

Main Results:

• Transthoracic echocardiography is the first-line imaging technique but may underestimate apical involvement.
• Cardiac MRI is the reference standard for defining apical morphology, quantifying hypertrophy, and tissue characterization.
• Echocardiography excels in real-time cardiac dynamics and identifying subtle obstructive gradients.

Conclusions:

• Echocardiography and CMR have complementary roles in diagnosing and managing AHC.
• CMR provides a research platform for developing new echocardiographic criteria for AHC.
• Methodological and conceptual benefits can be derived from integrating CMR findings into echocardiographic practice for AHC.