Open AccessApical Hypertrophic Cardiomyopathy: Correlations Between Echocardiographic Parameters, Angiographic Left Ventricular Morphology, and Clinical Outcomes
Author(s) -
Chen ChaoChin,
Lei MengHuan,
Hsu YuCheng,
Chung ShengLiang,
Sung YenJen
Publication year - 2011
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20874
Subject(s) - medicine , cardiology , hypertrophic cardiomyopathy , aneurysm , diastole , cardiac catheterization , left ventricular hypertrophy , heart aneurysm , concomitant , radiology , blood pressure
Abstract Background: Echocardiographic parameters could be implicated in the development of apical asynergy (characterized by apical sequestration or apical aneurysm) and worse cardiovascular outcome in patients with apical hypertrophic cardiomyopathy (ApHCM). Hypothesis: Echocardiographic parameters and morphological patterns of left ventriculograms are associated with cardiovascular morbidity and mortality in patients with ApHCM. Methods: We followed 47 cases with echocardiographically documented ApHCM. Echocardiographic findings of the extent and degree of hypertrophy, sustained cavity obliteration, and paradoxical diastolic jet flow were measured. All patients underwent a cardiac catheterization except for the cases whose informed consent was not acquired. The clinical manifestations were assessed and recorded by the attending physicians during 35.4 ± 23.7 months follow‐up. Results: Among the 47 patients with ApHCM, 30 patients presented as the “pure” form and 17 patients present as the “mixed” form. Seventeen of 28 patients with sustained cavity obliteration showed paradoxical flow by echocardiography. Thirty‐one underwent left ventriculograms and showed morphological abnormalities, including “ace‐of‐spades” configuration (15/31), apical sequestration (12/31), and apical aneurysm (4/31). The results demonstrated that cardiovascular morbidities occurred in 21 of 47 patients and were closely related to the presence of mixed form ApHCM, cavity obliteration, and paradoxical flow by univariate and multivariate Cox analysis. During the period of follow‐up, 4 patients (9.5%) died, and among them 3 had concomitant apical aneurysm. Conclusions: We concluded that detection of cavity obliteration and paradoxical flow and discrimination of pure form from mixed form by echocardiography, as well apical sequestration from apical aneurysm in ApHCM patients, is warranted. © 2011 Wiley Periodicals, Inc. This work was supported in part by grants from Lo‐Tung Poh‐Ai Hospital. The authors have no other funding, financial relationships, or conflicts of interest to disclose.