Optimizing imaging techniques in hypertrophic cardiomyopathy: challenges and opportunities.

Area of Science:

• Cardiovascular Imaging
• Cardiology
• Medical Imaging

Background:

• Imaging is vital for hypertrophic cardiomyopathy (HCM) evaluation and management.
• Current imaging practices show significant variability in acquisition, analysis, and interpretation.
• Methodological inconsistencies limit reproducibility and hinder multimodality integration in HCM care.

Purpose of the Study:

• To review technical challenges and optimization strategies for contemporary imaging modalities in HCM.
• To emphasize standardization and automation opportunities to reduce measurement variability.
• To highlight the importance of integrating multimodality imaging in clinical workflows.

Main Methods:

• Review of echocardiography for dynamic left ventricular outflow tract obstruction and mitral valve assessment.
• Analysis of cardiac magnetic resonance (CMR) uncertainties including fibrosis quantification, parametric mapping, and perfusion imaging.
• Examination of computed tomography (CT) and nuclear imaging applications for anatomic assessment, coronary evaluation, and microvascular dysfunction quantification.

Main Results:

• Identified key sources of measurement variability across echocardiography, CMR, CT, and nuclear imaging in HCM.
• Discussed current limitations and opportunities for standardization and automation in imaging analysis.
• Stressed the complementary use of multimodality imaging within tailored clinical workflows.

Conclusions:

• Optimizing imaging methodology is essential for consistent and meaningful improvements in HCM patient care.
• Standardization and automation are critical for enhancing the reliability of imaging findings.
• Integrated, complementary use of multimodality imaging improves clinical decision-making for hypertrophic cardiomyopathy.