Differential diagnosis of apical hypertrophic cardiomyopathy and apical displacement of the papillary muscles: a multimodality imaging point of view


ÜNLÜ S., Ozden Tok O., Avci Demir F., Papadopoulos K., Monaghan M. J.

ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, vol.38, no.1, pp.103-113, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 38 Issue: 1
  • Publication Date: 2021
  • Doi Number: 10.1111/echo.14895
  • Journal Name: ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.103-113
  • Keywords: cardiac imaging, cardiac magnetic resonance imaging, cardiomyopathy hypertrophic, computed tomography (CT), myocardial strain, radionuclide imaging, CARDIOVASCULAR MAGNETIC-RESONANCE, TOMOGRAPHY CORONARY-ANGIOGRAPHY, LATE GADOLINIUM ENHANCEMENT, OUTFLOW TRACT OBSTRUCTION, SYSTOLIC ANTERIOR MOTION, MITRAL-VALVE, COMPUTED-TOMOGRAPHY, MORPHOLOGICAL VARIATIONS, EUROPEAN ASSOCIATION, ABNORMALITIES
  • Gazi University Affiliated: Yes

Abstract

Apical hypertrophic cardiomyopathy (ApHCM) and apical displacement of papillary muscles (ADPM) are two different pathologies with a number of similar imaging findings that may hamper adequate diagnosis. While ApHCM is associated with increased rate of mortality, ADPM commonly presents with a benign course and differential diagnosis is of great importance. Clinical assessment and 2D echocardiography cannot sufficiently differentiate these conditions, however, and advanced echocardiographic methods may facilitate diagnosis. Although echocardiography is the first-line imaging method in the diagnostic algorithm, cardiac magnetic resonance imaging (CMRI) is the gold standard for evaluating patients due to good spatial resolution and myocardial tissue characterization abilities. When CMRI is contraindicated, cardiac computed tomography may be an alternative reliable method that can also give information about the coronary anatomy. Nuclear imaging may also provide supplementary data regarding hypertrophy and coronary arteries when there is a suspicion of ischemia.