Hypertrophic cardiomyopathy and LV hypertrophy
Hypertrophic cardiomyopathy and hypertensive remodeling can both produce increased myocardial mass and wall thickness, but their interpretation requires anatomy, tissue characterization, flow context, and clinical history.
- Modality
- Cine short-axis, LVOT cine, native T1, strain
- Pipeline step
- Clinical interpretation
- Outputs
- Mass, wall thickness, LVOT, T1, and strain phenotypes
- Maturity
- Clinician review draft
What clinicians look for
The first-pass reading pattern is LV mass, regional wall thickness, hypertrophy distribution, LV cavity size, LA remodeling, LVOT/aortic-root context, native T1, and strain. Increased wall thickness is not disease-specific and may overlap across hypertrophic cardiomyopathy, hypertension, amyloidosis, athlete remodeling, and aortic stenosis [1].
Relevant CardiacNexus phenotypes
| Phenotype page | Measurements to inspect | Interpretation role |
|---|---|---|
| Myocardial mass and wall thickness | LV mass, M/V ratio, segmental thickness | Hypertrophy burden and regional pattern |
| Ventricular mechanics and strain | Strain, strain rate, torsion | Mechanics altered by hypertrophy and fibrosis |
| Atrial structure | LA volume, LA dimensions, sphericity | Chronic filling-pressure and remodeling context |
| Valvular and flow phenotypes | LVOT/aortic-root geometry, velocity-derived outputs | Outflow and valve-related context |
| Myocardial tissue characterization | Native T1, corrected T1 | Diffuse fibrosis or infiltration context |
Interpretation patterns
Concentric or asymmetric hypertrophy should be interpreted together with cavity volume, atrial remodeling, strain, and tissue markers. Elevated native T1 can support diffuse myocardial abnormality, but values are scanner-, sequence-, and pipeline-dependent.
Limitations
CardiacNexus does not diagnose hypertrophic cardiomyopathy or separate it from hypertensive heart disease. Manual review is needed when basal septal segmentation, papillary muscles, or LVOT anatomy are ambiguous.
Source audit
- Draft primer checked against promoted myocardial mass, ventricular mechanics, atrial structure, valvular/flow, and myocardial tissue pages.
- Hypertrophy wording is kept as differential-context and remodeling-context language; CardiacNexus does not classify HCM, hypertensive heart disease, amyloidosis, athlete remodeling, or aortic stenosis.
docs/data/reference_sources.ymlexists and is the current registry for myocardial mass, T1, valve, and deformation-context sources.- Textbook context boundary: broad Braunwald/Hurst hypertrophic-cardiomyopathy and LVH background was treated only as clinical context; this page uses phenotype-specific evidence and does not need a separate textbook section for draft rollout.
- Textbook routes checked: Braunwald Hypertrophic Cardiomyopathy pages 172-184 and Systemic Hypertension pages 39-78. These chapters are broad differential context only; the page does not present diagnostic criteria or treatment thresholds.
References
- Mendez C, Soler R, Rodriguez E, Barriales R, Ochoa JP, Monserrat L. Differential Diagnosis of Thickened Myocardium: An Illustrative MRI Review. Insights into Imaging. 2018;9(5):695-707.
- Pantazis A, Vischer AS, Perez-Tome MC, Castelletti S. Diagnosis and Management of Hypertrophic Cardiomyopathy. Echo Research and Practice. 2015;2(1):R45-R53.
- Khouri MG, Peshock RM, Ayers CR, De Lemos JA, Drazner MH. A 4-Tiered Classification of Left Ventricular Hypertrophy Based on Left Ventricular Geometry: The Dallas Heart Study. Circulation: Cardiovascular Imaging. 2010;3(2):164-171.