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Mahmoud AK, Farina JM, Awad K, Pereyra M, Scalia IG, Abbas MT, Barry T, Alsidawi S, Ayoub C, Arsanjani R. Rapidly Progressive Apical Hypertrophic Cardiomyopathy: Not Everything is What It Seems. Methodist Debakey Cardiovasc J 2024; 20:54-58. [PMID: 38911827 PMCID: PMC11192092 DOI: 10.14797/mdcvj.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 06/25/2024] Open
Abstract
Apical hypertrophic cardiomyopathy (HCM) is a rare variant of HCM. A 43-year-old female with a past medical history significant for hypertension and kidney transplantation presented with recurrent syncopal episodes and dyspnea on exertion. Electrocardiogram showed characteristic diffuse giant T-waves inversion, and cardiac magnetic resonance showed HCM with circumferential apical thickening. This case highlights the rapid development of apical HCM and its challenging diagnostic characteristics.
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Li J, Fang J, Liu Y, Wei X. Apical hypertrophic cardiomyopathy: pathophysiology, diagnosis and management. Clin Res Cardiol 2024; 113:680-693. [PMID: 37982860 PMCID: PMC11026226 DOI: 10.1007/s00392-023-02328-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/18/2023] [Indexed: 11/21/2023]
Abstract
Since the first description of apical hypertrophic cardiomyopathy (ApHCM) in 1976, contrasting information from all over the world has emerged regarding the natural history of the disease. However, the recommended guidelines on hypertrophic cardiomyopathy (HCM) pay a cursory reference to ApHCM, without ApHCM-specific recommendations to guide the diagnosis and management. In addition, cardiologists may not be aware of certain aspects that are specific to this disease subtype, and a robust understanding of specific disease features can facilitate recognition and timely diagnosis. Therefore, the review covers the incidence, pathogenesis, and characteristics of ApHCM and imaging methods. Echocardiography and cardiovascular magnetic resonance imaging (CMR) are the most commonly used imaging methods. Moreover, this review presents the management strategies of this heterogeneous clinical entity. In this review, we introduce a novel transapical beating-heart septal myectomy procedure for ApHCM patients with a promising short-time result.
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Affiliation(s)
- Jiangtao Li
- Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, 430030, China
- Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China
- NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, China
| | - Jing Fang
- Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, 430030, China
- Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China
- NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, China
| | - Yani Liu
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, 430030, China.
| | - Xiang Wei
- Division of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, 430030, China.
- Key Laboratory of Organ Transplantation, Ministry of Education, Wuhan, China.
- NHC Key Laboratory of Organ Transplantation, Ministry of Health, Wuhan, China.
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Reilly C, Brown V, Correa GC, Acevedo HG, Kalivoda EJ. Bedside cardiac ultrasound evaluation of a young male with chest pain. J Am Coll Emerg Physicians Open 2023; 4:e13066. [PMID: 38029021 PMCID: PMC10663648 DOI: 10.1002/emp2.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Christopher Reilly
- Department of Emergency MedicineHospital Corporation of America Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education/Hospital Corporation of America Florida Brandon HospitalBrandonFloridaUSA
| | - Vegas Brown
- Department of Emergency MedicineHospital Corporation of America Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education/Hospital Corporation of America Florida Brandon HospitalBrandonFloridaUSA
| | - Gabriel Cabrera Correa
- Department of Emergency MedicineHospital Corporation of America Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education/Hospital Corporation of America Florida Brandon HospitalBrandonFloridaUSA
| | - Harold Gomez Acevedo
- Department of Emergency MedicineHospital Corporation of America Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education/Hospital Corporation of America Florida Brandon HospitalBrandonFloridaUSA
| | - Eric J. Kalivoda
- Department of Emergency MedicineHospital Corporation of America Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education/Hospital Corporation of America Florida Brandon HospitalBrandonFloridaUSA
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Menezes Fernandes R, Brandão M, Ladeiras Lopes R, Faria R, Dias Ferreira N, Fontes-Carvalho R. Myocardial deformation analysis using cardiac magnetic resonance in apical hypertrophic cardiomyopathy: is it an useful tool to predict adverse outcomes? THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1997-2003. [PMID: 37421577 DOI: 10.1007/s10554-023-02902-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/16/2023] [Indexed: 07/10/2023]
Abstract
Apical hypertrophic cardiomyopathy (AHCM) has a broad phenotypic spectrum and still poses many diagnostic and prognostic challenges. Our team performed a retrospective study to examine the prognostic value of myocardial deformation obtained with cardiac magnetic resonance tissue tracking (CMR-TT) analysis in predicting adverse events in AHCM patients. We included patients with AHCM referred to CMR in our department from August 2009 to October 2021. CMR-TT analysis was performed to characterize the myocardial deformation pattern. Clinical, other complementary diagnostic exams characteristics and follow-up data were analysed. Primary endpoint was the composite of all-cause hospitalizations and mortality. During the 12-year period, 51 AHCM patients were evaluated by CMR, with a median age of 64 years-old and male predominance. 56,9% had an echocardiogram suggestive of AHCM. The most frequent phenotype was "the relative form" (43,1%). CMR evaluation revealed a median maximum left ventricle thickness of 15 mm and the presence of late gadolinium enhancement in 78,4%. Applying CMR-TT analysis, median global longitudinal strain was - 14,4%, with a median global radial strain of 30,4% and global circumferential strain of -18,0%. During a median follow-up of 5,3 years, the primary endpoint occurred in 21,3% of patients, with a hospitalization rate of 17,8% and all-cause mortality rate of 6,4%. After multivariable analysis, longitudinal strain rate in apical segments was an independent predictor of the primary endpoint (p = 0,023), showing that CMR-TT analysis could be useful in predicting adverse events in AHCM patients.
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Affiliation(s)
- Raquel Menezes Fernandes
- Cardiology Department, Centro Hospitalar Universitário do Algarve - Hospital de Faro, Faro, Portugal.
- Algarve Biomedical Center, Faro, Portugal.
| | - Mariana Brandão
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ricardo Ladeiras Lopes
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Rita Faria
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Nuno Dias Ferreira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ricardo Fontes-Carvalho
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
- Cardiovascular R&D Centre - UnIC@RISE, Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Das A, Chowdhary A, Kelly C, Teh I, Stoeck CT, Kozerke S, Maxwell N, Craven TP, Jex NJ, Saunderson CED, Brown LAE, Ben-Arzi H, Sengupta A, Page SP, Swoboda PP, Greenwood JP, Schneider JE, Plein S, Dall'Armellina E. Insight Into Myocardial Microstructure of Athletes and Hypertrophic Cardiomyopathy Patients Using Diffusion Tensor Imaging. J Magn Reson Imaging 2021; 53:73-82. [PMID: 32558016 DOI: 10.1002/jmri.27257] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) remains the commonest cause of sudden cardiac death among young athletes. Differentiating between physiologically adaptive left ventricular (LV) hypertrophy observed in athletes' hearts and pathological HCM remains challenging. By quantifying the diffusion of water molecules, diffusion tensor imaging (DTI) MRI allows voxelwise characterization of myocardial microstructure. PURPOSE To explore microstructural differences between healthy volunteers, athletes, and HCM patients using DTI. STUDY TYPE Prospective cohort. POPULATION Twenty healthy volunteers, 20 athletes, and 20 HCM patients. FIELD STRENGTH/SEQUENCE 3T/DTI spin echo. ASSESSMENT In-house MatLab software was used to derive mean diffusivity (MD) and fractional anisotropy (FA) as markers of amplitude and anisotropy of the diffusion of water molecules, and secondary eigenvector angles (E2A)-reflecting the orientations of laminar sheetlets. STATISTICAL TESTS Independent samples t-tests were used to detect statistical significance between any two cohorts. Analysis of variance was utilized for detecting the statistical difference between the three cohorts. Statistical tests were two-tailed. A result was considered statistically significant at P ≤ 0.05. RESULTS DTI markers were significantly different between HCM, athletes, and volunteers. HCM patients had significantly higher global MD and E2A, and significantly lower FA than athletes and volunteers. (MDHCM = 1.52 ± 0.06 × 10-3 mm2 /s, MDAthletes = 1.49 ± 0.03 × 10-3 mm2 /s, MDvolunteers = 1.47 ± 0.02 × 10-3 mm2 /s, P < 0.05; E2AHCM = 58.8 ± 4°, E2Aathletes = 47 ± 5°, E2Avolunteers = 38.5 ± 7°, P < 0.05; FAHCM = 0.30 ± 0.02, FAAthletes = 0.35 ± 0.02, FAvolunteers = 0.36 ± 0.03, P < 0.05). HCM patients had significantly higher E2A in their thickest segments compared to the remote (E2Athickest = 66.8 ± 7, E2Aremote = 51.2 ± 9, P < 0.05). DATA CONCLUSION DTI depicts an increase in amplitude and isotropy of diffusion in the myocardium of HCM compared to athletes and volunteers as reflected by increased MD and decreased FA values. While significantly higher E2A values in HCM and athletes reflect steeper configurations of the myocardial sheetlets than in volunteers, HCM patients demonstrated an eccentric rise in E2A in their thickest segments, while athletes demonstrated a concentric rise. Further studies are required to determine the diagnostic capabilities of DTI. EVIDENCE LEVEL 1 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Arka Das
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Amrit Chowdhary
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Chris Kelly
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Irvin Teh
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Christian T Stoeck
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Sebastian Kozerke
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Nicholas Maxwell
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Thomas P Craven
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Nicholas J Jex
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Christopher E D Saunderson
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Louise A E Brown
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Hadar Ben-Arzi
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Anshuman Sengupta
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Stephen P Page
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Peter P Swoboda
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - John P Greenwood
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jurgen E Schneider
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Sven Plein
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Erica Dall'Armellina
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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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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Rowin EJ, Maron BJ, Maron MS. The Hypertrophic Cardiomyopathy Phenotype Viewed Through the Prism of Multimodality Imaging. JACC Cardiovasc Imaging 2020; 13:2002-2016. [DOI: 10.1016/j.jcmg.2019.09.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 12/16/2022]
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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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Leaphart D, Waring A, Suranyi P, Fernandes V. Call a Spade a Spade: Missed Diagnosis of Apical Hypertrophic Cardiomyopathy. Am J Med Sci 2019; 358:299-303. [PMID: 31353027 DOI: 10.1016/j.amjms.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/17/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
Abstract
Apical hypertrophic cardiomyopathy is a variant of hypertrophic cardiomyopathy characterized by apical hypertrophy, deep T-wave inversions in precordial electrocardiogram (EKG) leads, and a ventriculogram shaped like the "Ace of Spades." Patients are often asymptomatic but sometimes present with atypical chest pain, angina, or atrial fibrillation. The deep T-wave inversions on EKG often mimic acute coronary syndrome. Coronary angiogram in these patients is unrevealing, but the characteristic left ventriculogram establishes this diagnosis. The deep T-wave inversions can appear suddenly or deepen over years, making the diagnosis difficult to establish early in the disease. Transthoracic echocardiogram may miss the hypertrophied apex, but echo contrast imaging or cardiac magnetic resonance imaging can reliably confirm the diagnosis and detect apical aneurysms. We present a case of apical hypertrophic cardiomyopathy which was not evident despite many admissions, EKGs, cardiac catheterizations and echocardiograms until the diagnosis was confirmed with left ventriculogram and cardiac magnetic resonance imaging 20 years after initial presentation.
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Affiliation(s)
| | - Ashley Waring
- Heart and Vascular Center, Division of Cardiology and
| | - Pal Suranyi
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
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Zhou Y, Li D, Tang H, Xu Y, Wang C, Jiang Z, Xu F, Zhao Z, Li C, Tang S, Tang L, Zhou W. Development and validation of a new method to diagnose apical hypertrophic cardiomyopathy by gated single-photon emission computed tomography myocardial perfusion imaging. Nucl Med Commun 2019; 40:206-211. [PMID: 30570518 PMCID: PMC10961109 DOI: 10.1097/mnm.0000000000000967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIM The aim of this study is to develop and validate a new method to diagnose apical hypertrophic cardiomyopathy (AHCM) by the integral quantitative analysis of myocardial perfusion and wall thickening from gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). PATIENTS AND METHODS Twenty-two consecutive patients, who showed T wave inversion of at least 3 mm in precordial leads and sinus rhythm in ECG, were enrolled. All the patients underwent cardiac magnetic resonance (CMR), gated rest SPECT MPI and echocardiography. According to CMR diagnostic results, 13 patients were categorized as in the AHCM group and the remaining nine patients were categorized as in the non-AHCM group. Operators who were blinded to the CMR diagnosis independently performed the diagnosis by gated SPECT MPI. The regions of interest inside the apical hotspots on the perfusion polar map were drawn and the mean values of wall thickening in the drawn region of interests were calculated. Using MRI diagnosis as the gold standard, AHCM was diagnosed based on receiver operating characteristic analysis of the mean wall thickening in the apical perfusion hotspot. The area under curve, sensitivity, specificity, and accuracy of our method were 0.97, 100%, 89%, and 95%, respectively. CONCLUSION Our new method has high sensitivity, specificity, and accuracy against CMR diagnosis. It has great promise to become a clinical tool in the diagnosis of AHCM.
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Affiliation(s)
- Yanli Zhou
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Dianfu Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Haipeng Tang
- School of Computing, University of Southern Mississippi, Long Beach, Mississippi, USA
| | - Yi Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Cheng Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Zhixin Jiang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Fang Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Zhongqiang Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Chunxiang Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Shaojie Tang
- School of Automation, Xi’an University of Posts and Telecommunications, Xi’an, China
| | - Lijun Tang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - Weihua Zhou
- School of Computing, University of Southern Mississippi, Long Beach, Mississippi, USA
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Respuesta al ECG de octubre de 2016. Rev Esp Cardiol (Engl Ed) 2016. [DOI: 10.1016/j.recesp.2016.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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An Atypical Case of Apical Hypertrophic Cardiomyopathy: Absence of Giant T Waves in spite of Extreme Apical Wall Hypertrophy. Case Rep Cardiol 2015; 2015:980971. [PMID: 26779351 PMCID: PMC4686669 DOI: 10.1155/2015/980971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/26/2015] [Indexed: 11/17/2022] Open
Abstract
Apical hypertrophic cardiomyopathy is an uncommon variant of hypertrophic cardiomyopathy, with hypertrophy mainly affecting the apex of the left ventricle. We hereby describe a case of an octogenarian female patient who was randomly diagnosed with AHCM due to other comorbidities.
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