Apical hypertrophic cardiomyopathy: pathophysiology, diagnosis and management

Li, Jiangtao; Fang, Jing; Liu, Yani; Wei, Xiang

doi:10.1007/s00392-023-02328-8

Cited by 5 publications

(1 citation statement)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Current pharmacological treatment approaches mirror those of classic HCM and are aimed at prolonging diastole. Beta-blockers or calcium channel blockers are most commonly used for mid-ventricular obstruction, cavity obliteration, and ventricular arrhythmias [7]. In patients whose symptoms are severe or refractory to medical treatment, apical myectomy may be considered.…”

Section: Discussionmentioning

confidence: 99%

Apical Hypertrophic Cardiomyopathy: A Fatal yet Underappreciated Variant of Hypertrophic Cardiomyopathy

Eltawansy,

Klei,

Imburgio

et al. 2023

Cureus

View full text Add to dashboard Cite

Hypertrophic cardiomyopathy (HCM) is a group of diseases affecting the left ventricle heart muscle that share a common feature of left ventricular hypertrophy without associated cardiac or systemic disorder. It was found to have a genetic basis with autosomal dominant mutations in the sarcomeric protein genes. Apical HCM is a rare subtype and underappreciated variant of HCM that primarily affects the apex of the heart. Apical HCM is dissimilar to classic HCM, with more challenges in diagnosis and inconsistent clinical course than other types.We report a case of a 91-year-old female who presented with a syncopal episode. Workup revealed atypical nonclassic features. Her transthoracic echocardiogram revealed a "spade-like" configuration of the left ventricular cavity at end-diastole consistent with apical hypertrophic cardiomyopathy. The remaining of her workup was consistent with the apical hypertrophic cardiomyopathy as a reason for the syncopal episode on presentation.Apical HCM is a distinct form of HCM that requires more attention among clinicians. In our case, the patient ended up having an implantable cardioverter defibrillator (ICD) for secondary prevention and a prescription of a beta blocker with a good outcome in her case.

show abstract

Section: Discussionmentioning

confidence: 99%

Apical Hypertrophic Cardiomyopathy: A Fatal yet Underappreciated Variant of Hypertrophic Cardiomyopathy

Eltawansy,

Klei,

Imburgio

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

Clinical Implications of Left Ventricular Apex Mechanics in Patients With Apical Hypertrophic Cardiomyopathy

Wang,

Zhou,

Geske

et al. 2024

Journal of the American Society of Echocardiography

View full text Add to dashboard Cite

Clinical Characteristics and Outcomes in Patients With Apical and Nonapical Hypertrophic Cardiomyopathy

Chen,

Zou,

Katsouras

et al. 2024

JAHA

View full text Add to dashboard Cite

Background Apical hypertrophic cardiomyopathy (ApHCM) is a variant of hypertrophic cardiomyopathy, with distinct clinical characteristics and outcomes. We aimed to clarify the natural history of patients with ApHCM and identify the risk of end‐stage heart failure incidence. Methods and Results This retrospective study was conducted on patients with hypertrophic cardiomyopathy in China between January 2009 and February 2024. Patients were stratified into ApHCM and non‐ApHCM groups. The primary outcome was a composite of major adverse cardiovascular events, including all‐cause deaths, heart failure hospitalization, sudden cardiac death, and ventricular tachycardia. The secondary outcome was the incidence of end‐stage heart failure, defined as left ventricular ejection fraction <50%. Kaplan‐Meier and univariable and multivariable Cox proportional analyses were applied. Adjustment variables were included for important baseline characteristics, comorbidities, and medication use. Of 5653 patients enrolled with hypertrophic cardiomyopathy, 584 (10.3%) had ApHCM and 5069 (89.7%) had non‐ApHCM. During the median follow‐up period of 4.6 years (1.6–8.0 years), major adverse cardiovascular events occurred in 32.2% (n=1808), with a lower incidence in patients with ApHCM than non‐ApHCM (20.4% versus 33.3%, P <0.001). Non‐ApHCM was an independent predictor of major adverse cardiovascular events (hazard ratio [HR], 1.65 [95% CI, 1.36–1.99]; P <0.001). In the serial cohort, patients with ApHCM exhibited a lower incidence of end‐stage heart failure than those with non‐ApHCM (12.4% versus 2.7%, P <0.001). Non‐ApHCM was associated with a higher risk of end‐stage heart failure development (HR, 2.31 [95% CI, 1.28–4.15]; P <0.001). In subgroup and sensitivity analysis, the results were consistent for our main and secondary outcomes. Conclusions ApHCM is relatively common in hypertrophic cardiomyopathy and shows lower rates of all‐cause mortality and heart failure hospitalizations than non‐ApHCM.

show abstract

Apical hypertrophic cardiomyopathy: pathophysiology, diagnosis and management

Cited by 5 publications

References 81 publications

Apical Hypertrophic Cardiomyopathy: A Fatal yet Underappreciated Variant of Hypertrophic Cardiomyopathy

Apical Hypertrophic Cardiomyopathy: A Fatal yet Underappreciated Variant of Hypertrophic Cardiomyopathy

Clinical Implications of Left Ventricular Apex Mechanics in Patients With Apical Hypertrophic Cardiomyopathy

Clinical Characteristics and Outcomes in Patients With Apical and Nonapical Hypertrophic Cardiomyopathy

Contact Info

Product

Resources

About