Open AccessHypertrophic cardiomyopathy: Can the noninvasive diagnostic testing identify high risk patients?
Author(s) -
Li Zhang,
Obinna Mmagu,
Liwen Liu,
Dayuan Li,
Yuxin Fan,
Adrián Baranchuk,
Peter R. Kowey
Publication year - 2014
Publication title -
world journal of cardiology
Language(s) - English
Resource type - Journals
ISSN - 1949-8462
DOI - 10.4330/wjc.v6.i8.764
Subject(s) - medicine , hypertrophic cardiomyopathy , cardiology , sudden cardiac death , left ventricular hypertrophy , risk stratification , cardiac magnetic resonance imaging , muscle hypertrophy , myocardial fibrosis , genetic testing , ventricular tachycardia , ventricular fibrillation , cardiomyopathy , qrs complex , magnetic resonance imaging , risk assessment , fibrosis , heart failure , radiology , blood pressure , computer security , computer science
Hypertrophic cardiomyopathy (HCM) is the most common cause of sudden cardiac death (SCD) in the young, particularly among athletes. Identifying high risk individuals is very important for SCD prevention. The purpose of this review is to stress that noninvasive diagnostic testing is important for risk assessment. Extreme left ventricular hypertrophy and documented ventricular tachycardia and fibrillation increase the risk of SCD. Fragmented QRS and T wave inversion in multiple leads are more common in high risk patients. Cardiac magnetic resonance imaging provides complete visualization of the left ventricular chamber, allowing precise localization of the distribution of hypertrophy and measurement of wall thickness and cardiac mass. Moreover, with late gadolinium enhancement, patchy myocardial fibrosis within the area of hypertrophy can be detected, which is also helpful in risk stratification. Genetic testing is encouraged in all cases, especially in those with a family history of HCM and SCD.