The value of left ventricular angiography in the diagnosis of apical hypertrophic cardiomyopathy / 中华老年医学杂志

ABSTRACT

Objective To assess the diagnostic value of left ventricular angiography in patients with apical hypertrophic cardiomyopathy.Methods A total of 32 consecutively recruited patients aged from 61 to 78 with suspected apical hypertrophic cardiomyopathy from inconclusive apex imaging on conventional echocardiography from June 2016 to December 2017 underwent left ventricular opacification.A diagnosis of apical hypertrophic cardiomyopathy was made when the thickness of hypertrophied area of the apex was ＞ 1.5 cm,the ratio of the hypertrophied area to the non-hypertrophied area was ＞ 1.3,and no hypertrophy was found elsewhere.Results Twenty-four out of 32 patients (75.0％) were diagnosed with apical hypertrophic cardiomyopathy,all of whom had pure apical hypertrophy.The other 8 patients were excluded,with normal thickness in the apex.Patients with apical hypertrophic cardiomyopathy had apical wall thicknesses ranging from 15 mm to 21 mm,reduced myocardial motion amplitude in the apex and uneven echo at certain areas of the ventricular wall.All cases showed clear images of the apex with left ventricular opacification,and the apex of the heart lost its normal morphology and showed a pointed end,with ventricular cavity obliteration or uneven wall thickness in the apex.Conclusions Left heart ventricular angiography can be complimentary to conventional echocardiography in the diagnosis of apical hypertrophic cardiomyopathy by providing a clearer endocardial contour and more accurate estimates of apical wall thickness and therefore enhancing the diagnostic value of ultrasound for apical hypertrophic cardiomyopathy.