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Updated: Aug 6, 2026
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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Multimodality Imaging-Based Phenotyping and Prognostic Implications of Right Ventricular Involvement in Apical
Soongu Kwak1, Jihoon Kim2, Min-Ha Jeong1
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Cardiology, Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
JACC. Asia
|July 24, 2026
Summary
Right ventricular involvement in apical hypertrophic cardiomyopathy (HCM) indicates a worse prognosis. Advanced imaging can identify high-risk HCM phenotypes, improving patient risk stratification.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Genetics
Background:
- Right ventricular (RV) involvement is a known high-risk marker in hypertrophic cardiomyopathy (HCM).
- The prognostic significance of RV involvement specifically in apical HCM remains unclear.
- Apical HCM presents unique diagnostic and prognostic challenges.
Purpose of the Study:
- To determine the prognostic importance of RV involvement in apical HCM.
- To assess the added value of imaging-based phenotyping for risk stratification.
- To identify distinct patient subgroups with varying cardiovascular event risks.
Main Methods:
- Retrospective analysis of 289 patients with apical HCM.
- Utilized cardiovascular magnetic resonance (CMR) and strain echocardiography.
- Classified patients into purely apical, mixed, and RV involvement subtypes and used imaging-based clustering.
Main Results:
- RV involvement was observed in 24.2% of patients and was linked to a higher risk of cardiovascular (CV) events (aHR: 2.59).
- Imaging-based clustering identified two phenotypes; Cluster 2 showed greater hypertrophy, fibrosis, and impaired function, associated with higher CV event risk (aHR: 2.31).
- Patients in Cluster 2 with RV involvement had the highest risk of CV events (aHR: 4.02).
Conclusions:
- RV involvement is a significant predictor of adverse prognosis in apical HCM.
- Imaging-derived clusters combined with RV morphology enhance risk stratification for apical HCM.
- Personalized risk assessment can be improved by integrating imaging findings and RV status.
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