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(Circulation. 2000;101:e44.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Apical Hypertrophic Cardiomyopathy

Mirta Koelj, MD, PhD

Department of Cardiovascular Diseases University Medical Centre Ljubljana, Ljubljana, Slovenia

Duan Pavnik, MD, PhD

Dotter Interventional Institute Portland, Ore

Milan urlan, MD, PhD

Institute of Radiology University Medical Centre Ljubljana, Ljubljana, Slovenia

	Introduction

 
To the Editor:

In regard to the article by Reddy et al,¹ we would like to highlight the use of MRI in evaluation of hypertrophic cardiomyopathy, especially in asymmetrical forms, such as in apical hypertrophic cardiomyopathy.

MRI information concerning hypertrophic cardiomyopathy is provided in 3 planes (frontal, sagittal, and horizontal) and is complementary to that provided by echocardiography, isotopic techniques, and contrast angiography. This MRI accuracy can be particularly helpful in cases in which isolated asymmetrical hypertrophy should be differentiated from other cardiac masses.² Besides providing morphological information, MRI has potential for the evaluation of myocardium by suggesting the presence of infiltrative disease by tissue characterization.^{3 4} The advantages of MRI over 2D echocardiography include a large field of view and sharp interfaces that enable accurate myocardial evaluation for the location, severity, and extent of the abnormality with tissue characterization.^{4 5 6}

Radionuclide scanning has also been used in diagnosis of hypertrophic cardiomyopathy, but it showed myocardium only indirectly. MRI also has another advantage over radionuclide analysis because the patient is not exposed to the radiation.

	References

 
1. Reddy V, Korcarz C, Weinert L, Al-Sadir J, Spencer KT, Lang RM. Apical hypertrophic cardiomyopathy. Circulation. 1998;98:2354.[Free Full Text]

2. Koelj M, Pavnik D, urlan M. Asymmetric hypertrophic cardiomyopathy diagnosed by echocardiography and magnetic resonance imaging. Angiology. 1996;47:501–506.

3. Nishimura T, Nagata S, Sakakibara H. Magnetic resonance imaging in familial hypertrophic cardiomyopathy associated with abnormal thallium perfusion and cardiac enzymes. Jpn Circ J. 1988;52:395–400.[Medline] [Order article via Infotrieve]

4. Fattori R, Rocchi G, Celletti F, Bertaccini P, Rapezzi C, Gavelli G. Contribution of magnetic resonance imaging in the differential diagnosis of cardiac amyloidosis and symmetric hypertrophic cardiomyopathy. Am Heart J. 1998;136:824–830.[Medline] [Order article via Infotrieve]

5. Park JH, Kim YM, Chung JW, Park JB, Han JK, Han MC. MR imaging of hypertrophic cardiomyopathy. Radiology. 1992;185:441–446.[Abstract/Free Full Text]

6. Higgins CB, Byrd BF III, Stark D, McNamara M, Lanzer P, Lipton MJ, Schiller NB, Botvinick E, Chatterjee K. Magnetic resonance imaging in hypertrophic cardiomyopathy. Am J Cardiol. 1985;55:1121–1126.[Medline] [Order article via Infotrieve]

Response

Roberto M. Lang, MD; Claudia Korcarz, DVM; Vivek Reddy, MD; Lynn Weinert, BS; Kirk T. Spencer, MD; Jafar Al-Sadir, MD

University of Chicago Medical Center, Department of Medicine, Section of Cardiology, Chicago, Ill

	Introduction

 

We definitely agree with Dr Koelj and colleagues that MRI is useful in the evaluation of hypertrophic cardiomyopathy, especially in asymmetrical forms such as the apical variant.