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Title: Morphological abnormalities in hypertrophic cardiomyopathy - a cardiac mri based study
Authors: Vijayan G
Issue Date: Dec-2019
Publisher: SCTIMST
Abstract: Hypertrophic cardiomyopathy (HCM) has a varied clinical course due to its genotypic and phenotypic heterogeneity. Several autopsy studies have shown abnormalities of the mitral valve in some HCM patients. Cardiovascular magnetic resonance (CMR) has become the imaging modality of choice due to its high spatial resolution, well suited to define the diverse phenotypic expression of this complex disease. HCM has been documented to have various mitral valve abnormalities like an increased length of the leaflets and area, leaflet thickening, impaired mitral leaflet coaptation, and left ventricular outflow tract obstruction (LVOT) due to the systolic anterior motion of the mitral leaflets. Cardiovascular magnetic resonance (CMR) provides an excellent opportunity to assess the papillary muscle (PM) abnormalities like an increased number and mass, bifidity, hypertrophy, antero-apical displacement and LGE of the papillary muscle. Various guidelines recommend surgical myectomy as the preferred modality for patients with left ventricular outflow tract (LVOT) gradient ≥50 mm Hg who fail to respond to medications or who experience side effects. Alcohol septal ablation (ASA) in patients with mitral valve abnormalities results in persistent SAM, gradients, and mitral regurgitation (MR).
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