Hypertrophic CMP & echocardiography
LVH > 15 mm (not explainable otherwise; 1 or more involved segments)
Asymmetric LVH — anteroseptal/Inferolateral (HCM 1:1.5/HTN 1:1.3)
Eccentricity index IVS/PW > 1.5
Involved segments – 1 to all 17
Measurement LVH PLAX/PSAX
IVS often affected
HTN rarely >15 mm IVS
IVS ≥13 mm in 1° relatives of an HCM patient is diagnostic
All forms of myocardial wall thickening is possible
Localisations of maximal wall thickness
Strain in H(O)CMP
Thickening = Strain reduction
Regional differences in segmental strain analysis — more LVH equals more strain reduction
GLS more positive than -10% ➜ elevated risk for ventricular tachycardia / -10 to -16% ➜ worsening prognosis
Regional differences in segmental strain
HCMP case
Global Strain reduction -15,4%
Strain reduction where LVH is
Dispersion prolonged 82ms
HOCMP case
Severely reduced GLS -10,8%
High normal to hyperdynamic EF
Prolonged dispersion 75msec
Liu et al. Am J Cardiol 2017;120(4):670-675
Apical HCMP cases
Basal good contraction
Apical reduction in the hypertrophied segments & potentially „Blueberry on top“ sign; „Early“ time to peak Strain sometimes visible in the apical hypertrophied segments (here not measurable)
