Dentamaro Ilaria, Dicorato Marco Maria, Falagario Alessio, Cicco Sebastiano, Dentamaro Sergio, Correale Michele, Manuppelli Vincenzo, Citarelli Gaetano, Mangini Francesco, Fiore Corrado, Colonna Paolo, Petruccelli Enrica, Piscitelli Laura, Giovannetti Guido, Latorre Michele Davide, Forleo Cinzia, Basile Paolo, Carella Maria Cristina, Santobuono Vincenzo Ezio, Ciccone Marco Matteo, Guaricci Andrea Igoren
University Cardiology Unit, Interdisciplinary Department of Medicine, Polyclinic University Hospital, University of Bari "Aldo Moro", 70121 Bari, Italy.
Internal Medicine Unit "Guido Baccelli"-Arterial Hypertension Unit "Anna Maria Pirrelli", Department of Precision and Regenerative Medicine and Jonic Area (DiMePReJ), Polyclinic University Hospital, University of Bari "Aldo Moro", 70124 Bari, Italy.
Biomedicines. 2025 Sep 1;13(9):2138. doi: 10.3390/biomedicines13092138.
Hypertrophic cardiomyopathy (HCM) is a cardiac disorder characterized by unexplained left ventricular hypertrophy and a clinical presentation that is heterogeneous, ranging from asymptomatic cases to sudden cardiac death (SCD). The condition's complex pathophysiology encompasses myocyte disarray, fibrosis, and impaired cellular metabolism. Advancements in non-invasive cardiac imaging, notably echocardiography and cardiac magnetic resonance (CMR), have led to substantial progress in the domains of early diagnosis, phenotypic characterization, and risk stratification. Echocardiography is the preferred diagnostic modality, as it provides a comprehensive evaluation of ventricular hypertrophy patterns, left ventricular outflow tract (LVOT) obstruction, mitral valve abnormalities, left atrial size, and diastolic function. Novel techniques, such as speckle-tracking strain imaging, have emerged as means to detect subclinical myocardial dysfunction and to provide significant prognostic information. Cine-CMR sequences, tissue characterization with late gadolinium enhancement, and quantitative techniques such as strain imaging have been shown to enhance diagnostic precision and prognostic evaluation. The integration of multimodality imaging has been demonstrated to enhance the management of patients with HCM, both in the short term and in the long term, by facilitating individualized monitoring. This review summarizes the role of cardiac imaging in the comprehensive evaluation of HCM, emphasizing the impact of these methods on diagnosis, risk assessment, and personalized patient care, particularly in challenging clinical settings, such as cases of athlete's heart and pathological ventricular hypertrophy.
肥厚型心肌病（HCM）是一种以不明原因的左心室肥厚为特征的心脏疾病，其临床表现具有异质性，从无症状病例到心源性猝死（SCD）不等。该疾病复杂的病理生理学包括心肌细胞排列紊乱、纤维化和细胞代谢受损。非侵入性心脏成像技术的进步，尤其是超声心动图和心脏磁共振成像（CMR），在早期诊断、表型特征描述和风险分层领域取得了重大进展。超声心动图是首选的诊断方式，因为它能全面评估心室肥厚模式、左心室流出道（LVOT）梗阻、二尖瓣异常、左心房大小和舒张功能。斑点追踪应变成像等新技术已成为检测亚临床心肌功能障碍和提供重要预后信息的手段。电影CMR序列、钆延迟增强组织特征分析以及应变成像等定量技术已被证明可提高诊断准确性和预后评估。多模态成像的整合已被证明可通过促进个性化监测，在短期和长期内改善HCM患者的管理。本综述总结了心脏成像在HCM综合评估中的作用，强调了这些方法对诊断、风险评估和个性化患者护理的影响，特别是在具有挑战性的临床环境中，如运动员心脏和病理性心室肥厚的病例。
