Apical Hypertrophic Cardiomyopathy
To the Editor:
In regard to the article by Reddy et al,1 we would like to highlight the use of MRI in evaluation of hypertrophic cardiomyopathy, especially in asymmetrical forms, such as in apical hypertrophic cardiomyopathy.
MRI information concerning hypertrophic cardiomyopathy is provided in 3 planes (frontal, sagittal, and horizontal) and is complementary to that provided by echocardiography, isotopic techniques, and contrast angiography. This MRI accuracy can be particularly helpful in cases in which isolated asymmetrical hypertrophy should be differentiated from other cardiac masses.2 Besides providing morphological information, MRI has potential for the evaluation of myocardium by suggesting the presence of infiltrative disease by tissue characterization.3 4 The advantages of MRI over 2D echocardiography include a large field of view and sharp interfaces that enable accurate myocardial evaluation for the location, severity, and extent of the abnormality with tissue characterization.4 5 6
Radionuclide scanning has also been used in diagnosis of hypertrophic cardiomyopathy, but it showed myocardium only indirectly. MRI also has another advantage over radionuclide analysis because the patient is not exposed to the radiation.
- Copyright © 2000 by American Heart Association
Reddy V, Korcarz C, Weinert L, Al-Sadir J, Spencer KT, Lang RM. Apical hypertrophic cardiomyopathy. Circulation. 1998;98:2354.
Koz̆elj M, Pavc̆nik D, S̆urlan M. Asymmetric hypertrophic cardiomyopathy diagnosed by echocardiography and magnetic resonance imaging. Angiology. 1996;47:501–506.
We definitely agree with Dr Koz̆elj and colleagues that MRI is useful in the evaluation of hypertrophic cardiomyopathy, especially in asymmetrical forms such as the apical variant.