The Remarkable 50 Years of Imaging in HCM and How it Has Changed Diagnosis and ManagementFrom M-Mode Echocardiography to CMR
Author + information
- Received February 10, 2016
- Revision received May 2, 2016
- Accepted May 12, 2016
- Published online July 1, 2016.
Author Information
- Barry J. Maron, MD∗ (barrymaron1{at}gmail.com) and
- Martin S. Maron, MD
- Hypertrophic Cardiomyopathy Institute, Tufts Medical Center, Division of Cardiology, Boston, Massachusetts
- ↵∗Reprint requests and correspondence:
Dr. Barry J. Maron, HCM Institute, Tufts Medical Center, Division of Cardiology, 800 Washington Street, Box #70, Boston, Massachusetts 02111.
Abstract
The almost 50-year odyssey of cardiac imaging in hypertrophic cardiomyopathy (HCM), revisited and described here, has been remarkable, particularly when viewed in the timeline of advances that occurred during a single generation of investigators. At each step along the way, from M-mode to 2-dimensional echocardiography to Doppler imaging, and finally over the last 10 years with the emergence of high-resolution tomographic cardiac magnetic resonance (CMR), evolution of the images generated by each new technology constituted a paradigm change over what was previously available. Together, these advances have transformed the noninvasive diagnosis and management of HCM in a number of important clinical respects. These changes include a more complete definition of the phenotype, resulting in more reliable clinical identification of patients and family members, defining mechanisms (and magnitude) of left ventricular outflow obstruction, and novel myocardial tissue characterization (including in vivo detection of fibrosis/scarring); notably, these advances afford more precise recognition of at-risk patients who are potential candidates for life-saving primary prevention defibrillator therapy. This evolution in imaging as applied to HCM has indelibly changed cardiovascular practice for this morphologically and clinically complex genetic disease.
- cardiovascular imaging
- echocardiography
- heart failure
- hypertrophic cardiomyopathy
- magnetic resonance imaging
- sudden death
Footnotes
Dr. Barry J. Maron was formerly at the Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota. Both authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 10, 2016.
- Revision received May 2, 2016.
- Accepted May 12, 2016.
- 2016 American College of Cardiology Foundation