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Yang AL, Li L, Zhang ZH, Li XX, You XX, Sun J, Akram MF, Liu HH, Li SG. SPECT and STE: Which one is better in incremental prognostic value over CCTA. Int J Cardiol 2023; 377:20-21. [PMID: 36682691 DOI: 10.1016/j.ijcard.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Affiliation(s)
- Ao-Ling Yang
- Department of Geriatrics, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China; Department of Intensive Care Unit, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China
| | - Li Li
- Department of Geriatrics, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China.
| | - Zhao-Hui Zhang
- Department of Intensive Care Unit, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China
| | - Xin-Xin Li
- Department of Geriatrics, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China
| | - Xiao-Xue You
- Department of Geriatrics, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China; Department of Intensive Care Unit, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China
| | - Jin Sun
- Medical Innovation Research Office, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, 443002, Hubei, Yichang, China
| | | | - Hai-Hua Liu
- Department of Geriatrics, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China; Department of Intensive Care Unit, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China
| | - Shu-Guo Li
- Department of Geriatrics, The First College of Clinical Medical Sciences, China Three Gorges University, 443000, Hubei, Yichang, China
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Ünlü S, Özden Tok Ö, Avcı Demir F, Papadopoulos K, Monaghan MJ. Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view. Echocardiography 2020; 38:103-113. [PMID: 33067903 DOI: 10.1111/echo.14895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
Apical hypertrophic cardiomyopathy (ApHCM) and apical displacement of papillary muscles (ADPM) are two different pathologies with a number of similar imaging findings that may hamper adequate diagnosis. While ApHCM is associated with increased rate of mortality, ADPM commonly presents with a benign course and differential diagnosis is of great importance. Clinical assessment and 2D echocardiography cannot sufficiently differentiate these conditions, however, and advanced echocardiographic methods may facilitate diagnosis. Although echocardiography is the first-line imaging method in the diagnostic algorithm, cardiac magnetic resonance imaging (CMRI) is the gold standard for evaluating patients due to good spatial resolution and myocardial tissue characterization abilities. When CMRI is contraindicated, cardiac computed tomography may be an alternative reliable method that can also give information about the coronary anatomy. Nuclear imaging may also provide supplementary data regarding hypertrophy and coronary arteries when there is a suspicion of ischemia.
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Affiliation(s)
- Serkan Ünlü
- Department of Cardiology, Gazi University School of Medicine, Ankara, Turkey
| | - Özge Özden Tok
- Cardiology Department, Memorial Bahçelievler Hospital, İstanbul, Turkey
| | - Fulya Avcı Demir
- Cardiology Department, Private Antalya Anatolia Hospital, Antalya, Turkey
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Huang G, Fadl SA, Sukhotski S, Matesan M. Apical variant hypertrophic cardiomyopathy "multimodality imaging evaluation". Int J Cardiovasc Imaging 2019; 36:553-561. [PMID: 31853820 DOI: 10.1007/s10554-019-01739-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/23/2019] [Indexed: 12/21/2022]
Abstract
Apical variant hypertrophic cardiomyopathy (AHCM) is characterized by asymmetric hypertrophy of the left ventricular (LV) apex. T wave inversions of variable degree, particularly in the left precordial leads, and left ventricular hypertrophy (LVH) are common EKG findings in AHCM. Echocardiography is typically the initial imaging modality used in the diagnosis and evaluation of AHCM. The diagnosis is made when the LV apex has apical wall thickness of ≥ 15 mm or a ratio of apical to basal LV wall thickness of ≥ 1.3 at end-diastole. The use of microbubble contrast agents with echocardiography is helpful for visualization of the apex. Cardiac magnetic resonance (CMR) has the advantage of a large field of view and the ability to perform tissue characterization. Late gadolinium enhancement (LGE) sequences are essential in the assessment of potential areas of myocardial scarring. Cardiac computed tomography (CCT) has the advantage of being able to evaluate coronary arteries in addition to assessing cardiac anatomy and function. A "Solar Polar" map pattern is the characteristic feature of AHCM on myocardial perfusion imaging (MPI) in cases not associated with apical aneurysm (APA). Recognition of typical perfusion patterns in AHCM patients is not only important in the diagnostic evaluation of this disease process, but also for avoiding unnecessary and costly tests. The purpose of this article is to review the imaging features of AHCM from different imaging modalities and assess the value added of each modality in the diagnosis of AHCM.
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Affiliation(s)
- Gary Huang
- Department of Cardiology, University of Washington Medical Center, Seattle, WA, USA
| | - Shaimaa A Fadl
- Department of Radiology, Virginia Commonwealth University (VCU) Health System, Richmond, VA, USA.
| | - Stan Sukhotski
- Department of Nuclear medicine, University of Washington Medical Center, Seattle, WA, USA
- Department of Radiology, University of Washington Medical Center, Seattle, WA, USA
| | - Manuela Matesan
- Department of Nuclear medicine, University of Washington Medical Center, Seattle, WA, USA
- Department of Radiology, University of Washington Medical Center, Seattle, WA, USA
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