Inclusion of the Right Ventricular Muscle Bundle During Interventricular Septal Measurement Improves Diagnostic Accuracy for Hypertrophic Cardiomyopathy.
Introduction: Measurement of the interventricular septum (IVS) is a key diagnostic and prognostic parameter in the evaluation of hypertrophic cardiomyopathy (HCM). Right ventricular muscle bundles (RVMB) that parallel the IVS complicate septal measurement on both echocardiography and magnetic resona...
| Publicado en: | Echocardiography Vol. 42; no. 9; pp. 1 - 7 |
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| Autores principales: | , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188159106&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188159106 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Sep2025 vid: 42 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 188159106 188159106 188159106 10.1111/echo.70299 188159106 ppf: 1 ppct: 6 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Inclusion of the Right Ventricular Muscle Bundle During Interventricular Septal Measurement Improves Diagnostic Accuracy for Hypertrophic Cardiomyopathy. aug: au: Spevack, Daniel M. Ranjan, Pragya Khachatoorian, Yeraz Broker, Michael Kim, Chan Woo Nevin, Kerry Sharma, Mala Malhotra, Divya Naidu, Srihari affil: Department of Cardiology, Westchester Medical Center, Valhalla New York,, USA sug: subj: Heart Ventricle, Right Physiology Heart Septum Physiology Cardiomyopathy, Hypertrophic Diagnosis Diagnosis, Laboratory Human Male Female Retrospective Design Adult Middle Age Aged Echocardiography Magnetic Resonance Imaging Practice Guidelines Confidence Intervals ROC Curve Record Review T-Tests Chi Square Test Mann-Whitney U Test Prospective Studies Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Introduction: Measurement of the interventricular septum (IVS) is a key diagnostic and prognostic parameter in the evaluation of hypertrophic cardiomyopathy (HCM). Right ventricular muscle bundles (RVMB) that parallel the IVS complicate septal measurement on both echocardiography and magnetic resonance imaging. Current guideline statements reference left ventricular wall thickness measurements greater than or equal to 15 mm as part of the diagnostic criteria for HCM. The medical literature lacks published data on the impact of including RVMB as part of the IVS measurement and its influence on diagnostic accuracy for HCM. Methods: We measured the IVS and RVMB separately on echocardiography in 97 consecutive subjects referred for both echocardiography and magnetic resonance imaging (MRI) as part of the initial evaluation for HCM. Subjects were categorized as having or not having HCM based on current practice guidelines. Patients with HCM were sub‐categorized as having septal involvement (HCM‐Sep) or primarily apical hypertrophy (HCM‐Ap). This was done because subjects with obvious HCM‐Ap could be diagnosed with HCM irrespective of IVS thickness. Results: Compared to subjects who did not have HCM, those with HCM‐Sep had both increased IVS (15.4 ± 2.7 vs. 9.8 ± 1.9 mm, p < 0.001) and RVMB thickness (5.2 ± 3.1 vs. 1.9 ± 1.9 mm, p < 0.001). In the whole study group, the area under the receiver operating characteristic (ROC) curve for HCM was higher (0.83 [95% confidence interval (CI): 0.75, 0.91]) when the RVMB was included in the IVS measurement compared to when it was excluded (0.75 [95% CI: 0.68, 0.81]). When the subjects with HCM‐Ap were excluded, the area under the ROC curve for HCM was higher (0.94 [95% CI: 0.89, 0.99]) when the RVMB was included in the IVS measurement compared to when it was excluded (0.82 [95% CI: 0.75, 0.89]). The number of subjects classified correctly for HCM improved from 78% to 94% when the RVMB was included. Conclusions: Inclusion of the RVMB in the measurement of IVS thickness on echocardiography may improve overall diagnostic accuracy for HCM. In addition, RVMB thickness is increased and is more often visible on parasternal long‐axis imaging in subjects with HCM, consistent with being part of the HCM pathology. This is particularly true in those with HCM‐Sep. These data have implications for the standardization of echocardiographic and MRI reporting in HCM. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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