Diagnostics of rare forms of asymmetrical hypertrophic cardiomyopathy


DOI: https://dx.doi.org/10.18565/therapy.2024.9.140-146

Golosova A.N., Gatsura S.V., Finashova N.M.

1) Russian University of Medicine of the Ministry of Healthcare of Russia, Moscow; 2) V.P. Demikhov City Clinical Hospital of the Department of Healthcare of Moscow
Abstract. The article presents a clinical example of an asymptomatic obstructive form of hypertrophic cardiomyopathy (HCM) with obstruction locus localized in the middle part of the left ventricular (LV) cavity. In case of apical asymmetric form of HCM (in our variant, with involvement of the mid-LV segments), there is no connection between the obstruction and anterior systolic movement of anterior mitral valve leaflet, so it could be missed during an echocardiographic (EchoCG) examination. The suspicion of the presence of HCM in asymptomatic patients is formed during the analysis of resting electrocardiography (ECG), and the methods for this diagnosis confirmation are ECG and magnetic resonance imaging. The purpose of the publication is to increase doctors’ awareness in recognizing ECG signs of HCM in patients, which can allow to make a targeted examination of the ventricular cavity for HCM echocardiographic signs detection.
Keywords: myocardial fibrosis of non-ischemic genesis, Holter monitoring of the electrocardiogram, magnetic resonance imaging of heart with contrast, electrocardiogram, echocardiography, hypertrophic cardiomyopathy
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Literature

1. Габрусенко С.А., Гудкова А.Я., Козиолова Н.А. с соавт. Гипертрофическая кардиомиопатия. Клинические рекомендации 2020. Российский кардиологический журнал. 2021; 26(5): 269–334. (Gabrusenko S.A., Gudkova A.Ya., Koziolova N.A. et al. 2020 clinical practice guidelines for hypertrophic cardiomyopathy. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2021; 26(5): 269–334 (In Russ.)).


https://doi.org/10.15829/1560-4071-2021-4541. EDN: MXDYLE.


2. Habis A., Charles I., Paul J.-F. Hypertrophic midventricular obstructive cardiomyopathy revealed by a stroke. JACC Case Rep. 2019; 1(1): 62–63.


https://doi.org/10.1016/j.jaccas.2019.04.002. PMID: 34316745. PMCID: PMC8289139.


3. Licordari R., Trimarchi G., Teresi L. Cardiac magnetic resonance in HCM phenocopies: From diagnosis to risk stratification and therapeutic management. J Clin Med. 2023; 12(10): 3481.


https://doi.org/10.3390/jcm12103481. PMID: 37240587. PMCID: PMC10218866.


4. Maron M.S., Rowin E.J., Lin D. et al. Prevalence and clinical profile of myocardial crypts in hypertrophic cardiomyopathy. Circ Cardiovasc Imaging. 2012; 5(4): 441–47.


https://doi.org/10.1161/circimaging.112.972760. PMID: 22563033.


5. Elliott P.M., Anastasakis A., Borger M.A. et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: The Task Force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014; 35(39): 2733–79.


https://doi.org/10.1093/eurheartj/ehu284. PMID: 25173338.


6. Captur G., Lopes L.R., Mohun T.J. et al. Prediction of sarcomere mutations in subclinical hypertrophic cardiomyopathy. Circ Cardiovasc Imaging. 2014; 7(6): 863–71.


https://doi.org/10.1161/circimaging.114.002411. PMID: 25228707. PMCID: PMC4237712.


7. Goff Z.D., Calkins H. Sudden death related cardiomyopathies – Hypertrophic cardiomyopathy. Prog Cardiovasc Dis. 2019; 62(3): 212–16.


https://doi.org/10.1016/j.pcad.2019.04.001. PMID: 31004609.


8. Olivotto I., Cecchi F., Poggesi C., Yacoub M.H. Patterns of disease progression in hypertrophic cardiomyopathy: an individualized approach to clinical staging. Circ Heart Fail. 2012; 5(4): 535–46.


https://doi.org/10.1161/circheartfailure.112.967026. PMID: 22811549.


9. Desai M., Mentias A. Risk stratification in hypertrophic cardiomyopathy. Aging (Albany NY). 2019; 11(6): 1617–18.


https://doi.org/10.18632/aging.101895. PMID: 30923259. PMCID: PMC6461180.


10. Mentias A., Raeisi-Giglou P., Smedira N.G. et al. Late gadolinium enhancement in patients with hypertrophic cardiomyopathy and preserved systolic function. J Am Coll Cardiol. 2018; 72(8): 857–70.


https://doi.org/10.1016/j.jacc.2018.05.060. PMID: 30115224.


11. Yamagushi H., Ishimura T., Nishiyama S. et al. Hypertrophic nonobstructive cardiomyopathy with giant negative T waves (apical hypertrophy): Ventriculographic and echocardiographic features in 30 patients. Am J Cardiol. 1979; 44(3): 401–12.


https://doi.org/10.1016/0002-9149(79)90388-6. PMID: 573056.


12. Ommen S.R., Ho C.Y., Asif I.M. et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the management of hypertrophic cardiomyopathy: A report of the American Heart Association / American College of Cardiology joint committee on clinical practice guidelines Circulation. 2024; 149(23): e1239–e1311.


https://doi.org/10.1161/CIR.0000000000001250. PMID: 38718139.


13. Finocchiaro G., Sheikh N., Biagini E. et al. The electrocardiogram in the diagnosis and management of patients with hypertrophic cardiomyopathy. Heart Rhythm. 2020; 17(1): 142–51.


https://doi.org/10.1016/j.hrthm.2019.07.019. PMID: 31349064.


About the Autors

Alla N. Golosova, MD, PhD (Medicine), associate professor of the Department of hospital therapy No. 1 of the Faculty of general medicine, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: golosovaalla@mail.ru
ORCID: https://orcid.org/0000-0002-2562-9839
Sergey V. Gatsura, MD, Dr. Sci. (Medicine), professor of the Department of hospital therapy No. 1 of the Faculty of general medicine, Russian University of Medicine of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 4 Dolgorukovskaya St.
E-mail: svgats@mail.ru
ORCID: https://orcid.org/0000-0002-1513-5149
Natalya M. Finashova, MD, cardiologist at the Outpatient and Polyclinic Center, V.P. Demikhov City Clinical Hospital the of Department of Healthcare of Moscow. Address: 109263, Moscow, 4 Shkuleva St.
E-mail: fin-nata1@yandex.ru


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