Cardiac MRI in Diagnosis and Management of HCM
摘要
Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by left ventricular hypertrophy (>15 mm in thickness), often associated with significant heterogeneity in morphology, pathophysiology, clinical presentation, and prognosis. Cardiovascular magnetic resonance (CMR) has emerged as an essential imaging modality in the evaluation and management of HCM due to its unparalleled ability to provide high-resolution, three-dimensional visualization of cardiac anatomy, tissue characterization, and functional assessment. This chapter explores the pivotal role of CMR in diagnosing and phenotyping HCM, including its ability to accurately measure wall thickness, detect apical or atypical hypertrophy, assess presence of myocardial fibrosis, and distinguish HCM from other causes of left ventricular hypertrophy. The prognostic significance of CMR findings, such as the extent of LGE and its association with arrhythmic risk and adverse outcomes, is also discussed. Additionally, CMR-guided risk stratification plays a vital role in identifying candidates for implantable cardioverter-defibrillators (ICDs). This chapter also highlights the clinical utility of CMR in guiding treatment decisions. The integration of CMR into routine clinical practice provides a comprehensive and non-invasive approach to improving diagnostic accuracy, risk stratification, and personalized management of patients with HCM.