Cross-sectional study
Apical Aneurysms and Mid–Left Ventricular Obstruction in Hypertrophic Cardiomyopathy
- Cross-sectional study
- 3 dedicated programs
- echocardiography and CMR
Authors' conclusion
The great majority (95%) of patients in the continuum of apical aneurysms have associated mid-LV obstruction.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) apical left ventricular (LV) aneurysms from 3 dedicated programs
- Participants
- 108 / 63 / 47
- Exposure
- HCM apical aneurysm patients vs normal controls and apical-mid HCM controls without aneurysms
- Aneurysmn = 108
- Normal controlsn = 63reference
- Apical-mid HCM controlsn = 47reference
- Outcome
- Frequency of mid-LV obstruction in HCM apical aneurysms
Main finding
As reported in the abstract
Mid-LV obstruction with mid-LV complete systolic emptying
Aneurysm
95%
103 of 108
Observational data: associations, not effects.
Further findings
Doppler findings among patients with mid-LV obstruction
- Midsystolic Doppler signal void (marker of complete flow cessation)
- 84%
- Doppler systolic gradients ≥30 mm Hg
- 19%
Relative mid-LV hypokinesia without obstruction
- Patients with relative hypokinesia in mid-LV without obstruction
- 5 (5%)
Short-axis (SAX) papillary muscle areas: aneurysm vs elevated LV velocities without aneurysm
- Aneurysm: SAX papillary muscle (PM) area, median (IQR)
- 3.00 cm² (2.38-3.70 cm²)
- Elevated LV velocities, no aneurysm: SAX PM area, median (IQR)
- 2.45 (1.81-2.95 cm²)
- SAX PM areas 22% greater with aneurysm
- P = 0.004
Mid-LV obstruction aneurysm vs all control groups (SAX and PM measures)
- SAX systolic areas smaller
- P < 0.007
- Percent SAX area change greater
- P < 0.005
- PM areas larger
- P < 0.003
- Diastolic PM areas/SAX diastolic areas greater
- P < 0.005
Original publication
Apical Aneurysms and Mid–Left Ventricular Obstruction in Hypertrophic Cardiomyopathy. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.1016/j.jcmg.2022.11.013
Summarised from the published abstract; every number is checked against it