Left Ventricular Outflow Obstruction

ABCIC

Editorial

Hypertrophic Cardiomyopathy: Standardization of Echocardiographic Assessment in an Era of New Therapies

Hypertrophic cardiomyopathy (HCM) has become the most common inherited myocardial disease, with an estimated global prevalence between 1:200 and 1:500. Despite its relatively high frequency in the general population, the disease remains significantly underdiagnosed. Only about 15% of affected individuals are clinically identified, due mainly to the wide variability of phenotypes and clinical manifestations.^, Slightly more than half of patients may develop progressive symptoms or experience adverse events throughout their lifetime. Early identification, risk stratification, and cardiovascular therapies and interventions have reduced mortality rates to < 1.0% per year.

The pathophysiology of HCM is based on myocardial hypertrophy in the absence of secondary causes, associated with hypercontractility and diastolic dysfunction, resulting from abnormal myosin activation. Approximately 75% of patients present with left ventricular outflow tract (LVOT) obstruction at rest or after provocative maneuvers. In the absence of an obstructive pattern, the disease course is usually favorable, oligosymptomatic, or asymptomatic, with a minority progressing to advanced stages.^–

[…]

Read Full Article

ABCIC

Editorial

Tips and Pitfalls on the Role of Echocardiography in Percutaneous Intervention for Hypertrophic Cardiomyopathy

Claudio Henrique Fischer et al. Alessandra Joslin Oliveira

Hypertrophic cardiomyopathy (HCM) is the most prevalent genetic heart disease, affecting approximately 1 in 500 individuals in the general population,^– with asymmetric septal hypertrophy as the most common phenotype. In obstructive HCM (oHCM), clinical relevance is greater due to its association with atrial fibrillation, heart failure, thromboembolic events, arrhythmias, and sudden cardiac death.^, For patients who remain symptomatic despite optimized medical therapy, septal reduction has become an established strategy, with surgical septal myectomy as the gold standard. Alcohol septal ablation is an alternative when surgical risk is prohibitive, there are contraindications to surgery, advanced age, or favorable coronary anatomy; it should be performed in experienced centers.^– Other percutaneous approaches — such as radiofrequency septal ablation, the use of coils, or liquid embolic agents — have also been described.

Echocardiography plays a central role throughout the management of oHCM undergoing percutaneous intervention. Beyond diagnosis, it is essential for periprocedural guidance and for postoperative assessment. Understanding its capabilities and recognizing potential pitfalls are critical to success. This editorial offers practical tips for echocardiographers and highlights key points that, if overlooked, may compromise outcomes.

[…]

Read Full Article

ABCIC

Editorial

Radiofrequency in Obstructive Hypertrophic Cardiomyopathy: The Role of Imaging in the Assessment of Septal Thickness and Gradient Reduction

Alexandre Costa Souza et al. Marcus Vinicius Silva Freire de Carvalho

Obstructive hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by pronounced myocardial hypertrophy and varying degrees of fibrosis. The obstruction of the left ventricular outflow tract (LVOT) is an anatomical condition with dynamic behavior that can lead to symptoms such as exercise intolerance and reduced functional class, and is also associated with cases of sudden cardiac death.

The indication for invasive treatment aimed at reducing the intraventricular gradient is reserved for symptomatic patients —those who are refractory to medical therapy — with a gradient ≥ 50 mmHg. Common interventional therapies for this condition include surgical myectomy or, in a less invasive approach, alcohol septal ablation of coronary septal branches. However, these interventions have shown highly variable outcomes in the literature and remain infrequently used in clinical practice.^,

[…]

Read Full Article

Hypertrophic Cardiomyopathy: Standardization of Echocardiographic Assessment in an Era of New Therapies

Tips and Pitfalls on the Role of Echocardiography in Percutaneous Intervention for Hypertrophic Cardiomyopathy

Radiofrequency in Obstructive Hypertrophic Cardiomyopathy: The Role of Imaging in the Assessment of Septal Thickness and Gradient Reduction

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)