Assessing myocardial bridging and left ventricular configuration by 64-slice computed tomography in patients with apical hypertrophic cardiomyopathy presenting with chest pain

OBJECTIVE

We aimed to assess the usefulness of multislice computed tomographic (CT) angiography to detect coronary artery disease (CAD), including myocardial bridging (MB) and left ventricular morphology (LVG), in patients with apical hypertrophic cardiomyopathy (AHCM) who presented with angina and apical asynergy.

MATERIALS AND METHODS

Sixty-four-slice CT angiography was performed in 14 patients with echocardiographically diagnosed AHCM who presented with typical or atypical chest pain. Coronary angiography was performed in 7 patients because of either suspected CAD or echocardiographic apical hypokinesia. We assessed the correlations between coronary anatomy, apical thickness, and LV configuration that were determined by echocardiography, LVG, and 64-slice CT angiography.

RESULTS

The multislice CT confirmed the diagnosis of AHCM in 14 patients. The LVGs were all compatible between the 64-slice CT angiography and the LVG in the 7 patients who had "ace-of-spades" configurations, apical sequestrations, and an apical aneurysm. Furthermore, 2 significant CADs and 7 MBs were detected by 64-slice CT angiography.

CONCLUSIONS

Multislice CT can offer high accuracy for the noninvasive detection of apical wall thickness and left ventricular configuration in patients with AHCM. It also provides additional information about significant coronary stenosis and MB in patients with chest pain. This promising technology has a potential to complement invasive cardiac catheterization in clinical practice.