Spirito–Maron Echocardiographic Score: A Marker for Morphological and Physiological Assessment of Patients with Hypertrophic Cardiomyopathy

Aims The heterogeneous distribution of hypertrophy in hypertrophic cardiomyopathy ( HCM ) limits the echocardiographic conventional measurements accuracy in the evaluation of left ventricular hypertrophy ( LVH ). The aim of this study was to assess the correlation of the echocardiographic Spirito–Maron score ( SMS ) with left ventricle ( LV ) mass quantification by cardiac magnetic resonance ( CMR ) and with LV diastolic function. Methods and Results Left ventricle diastolic function parameters, SMS , LV mass (American Society of Echocardiography formula), and maximal wall thickness ( MWT ) were evaluated by two‐dimensional (2D) transthoracic echocardiography. The SMS was obtained by adding the MWT of 4 LV segments, at the mitral valve or papillary muscles short‐axis views. Echocardiographic parameters of LVH , including SMS , were correlated with LV mass obtained by CMR and with E/e′ ratio. We included 45 patients (60% male, mean age 48 ± 18 years), who underwent 2D echocardiography. Twenty‐two of them performed a CMR study. A positive correlation was found between SMS and CMR LV mass (r = 0.80; P < 0.001), whereas MWT (r = 0.62; P = 0.002) and the 2D LV mass (r = 0.60; P = 0.011) presented a lower correlation with CMR LV mass. The SMS was significantly correlated with E/e′ ratio (r = 0.60; P = 0.007), whereas a nonsignificant correlation was found with MWT (r = 0.41; P = 0.081) and 2D LV mass (r = 0.22; P = 0.400). Conclusion Spirito–Maron score presents a highly positive correlation with CMR LV mass and with diastolic dysfunction severity in HCM patients. SMS is a reliable quantitative LVH measurement method and seems to provide more comprehensive morphological and physiological information than 2D echocardiographic conventional parameters used to estimate LVH .