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Obstruction in Hypertrophic Cardiomyopathy: Many Faces

Abbasi, Muhannad, Ong, Kevin C., Newman, D. Brian, Dearani, Joseph A., Schaff, Hartzell V., Geske, Jeffrey B.·2024·Journal of the American Society of Echocardiography
DOI 10.1016/j.echo.2024.02.010
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Abstract

Hypertrophic cardiomyopathy (HCM), the most common inherited cardiomyopathy, exhibits left ventricular hypertrophy not secondary to other causes, with varied phenotypic expression. Enhanced actin-myosin interaction underlies excessive myocardial contraction, frequently resulting in dynamic obstruction within the left ventricle. Left ventricular outflow tract obstruction, occurring at rest or with provocation in 75% of HCM patients, portends adverse prognosis, contributes to symptoms, and is frequently a therapeutic target. Transthoracic echocardiography plays a crucial role in the screening, initial diagnosis, management, and risk stratification of HCM. Herein, we explore echocardiographic evaluation of HCM, emphasizing Doppler assessment for obstruction. Echocardiography informs management strategies through noninvasive hemodynamic assessment, which is frequently obtained with various provocative maneuvers. Recognition of obstructive HCM phenotypes and associated anatomical abnormalities guides therapeutic decision-making. Doppler echocardiography allows monitoring of therapeutic responses, whether it be medical therapies (including cardiac myosin inhibitor therapy) or septal reduction therapies, including surgical myectomy and alcohol septal ablation. This article discusses the hemodynamics of obstruction and practical application of Doppler assessment in HCM. In addition, it provides a visual atlas of obstruction in HCM, including high-quality figures and complementary vid…

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Metadata

Authors
Abbasi, M., Ong, K. C., Newman, D. B., Dearani, J. A., Schaff, H. V., & Geske, J. B.
Venue
Journal of the American Society of Echocardiography
Publisher
Elsevier BV
Published
2024-06
Volume
37
Issue
6
Pages
613-625
ISSN
0894-7317
DOI
10.1016/j.echo.2024.02.010
Cited by
49
References
0
Language
en
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CoChat. (2026). Citation check: Obstruction in Hypertrophic Cardiomyopathy: Many Faces. https://app.cochat.ai/papers/10.1016/j.echo.2024.02.010
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Abbasi, M., Ong, K. C., Newman, D. B., Dearani, J. A., Schaff, H. V., & Geske, J. B. (2024). Obstruction in Hypertrophic Cardiomyopathy: Many Faces. Journal of the American Society of Echocardiography. https://doi.org/10.1016/j.echo.2024.02.010