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Heart Failure Reviews
Published in: Heart Failure Reviews 6/2021

01-11-2021 | Sudden Cardiac Death

Fibrosis in hypertrophic cardiomyopathy: role of novel echo techniques and multi-modality imaging assessment

Authors: Efstathios D. Pagourelias, Georgios M. Alexandridis, Vassilios P. Vassilikos

Published in: Heart Failure Reviews | Issue 6/2021

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Abstract

Hypertrophic cardiomyopathy (HCM) represents one of the primary cardiomyopathies and may lead to heart failure and sudden cardiac death. Among various histologic features of the disease examined, assessment of myocardial fibrosis may offer valuable information, since it may be considered the common nominator for all HCM connected complications. Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) has emerged as the reference noninvasive method for visualizing and quantifying myocardial fibrosis in patients with HCM. T1 mapping, a promising new CMR technique, may provide an advantage over conventional LGE-CMR, by permitting a more valid quantification of diffuse fibrosis. On the other hand, echocardiography offers a significantly more portable, affordable, and easily accessible solution for the study of fibrosis. Various echocardiographic techniques ranging from integrated backscatter and contrast-enhanced ultrasound to two- (2D) or three-dimensional (3D) deformation and shear wave imaging may offer new insights into substrate characterization in HCM. The aim of this review is to describe thoroughly all different modalities that may be used in everyday clinical practice for HCM fibrosis evaluation (with special focus on echocardiographic techniques), to concisely present available evidence and to argue in favor of multi-modality imaging application. It is essential to understand that the role of various imaging modalities is not competitive but complementary, since the information provided by each one is necessary to illuminate the complex pathophysiologic pathways of HCM, offering a personalized approach and treatment in every patient.
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Metadata
Title
Fibrosis in hypertrophic cardiomyopathy: role of novel echo techniques and multi-modality imaging assessment
Authors
Efstathios D. Pagourelias
Georgios M. Alexandridis
Vassilios P. Vassilikos
Publication date
01-11-2021
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 6/2021
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-020-10058-6

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