Apical Hypertrophic Cardiomyopathy: Diagnosis, Natural History, and Management

Pavlos Rouskas; Sotiris Katranas; Thomas Zegkos; Thomas Gossios; Despoina Parcharidou; Georgios Tziomalos; Natassa Filippou; Dimitrios Tsalikakis; Matthaios Didagelos; Vassilios Kamperidis; Theodoros Karamitsos; Antonios Ziakas; Georgios K Efthimiadis

doi:10.1097/CRD.0000000000000579

Apical Hypertrophic Cardiomyopathy: Diagnosis, Natural History, and Management

Cardiol Rev. 2023 Jul 3. doi: 10.1097/CRD.0000000000000579. Online ahead of print.

Affiliations

¹ From the First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.
² Department of Informatics and Telecommunication Engineering, University of Western Macedonia, Kozani, Greece.

PMID: 37395574
DOI: 10.1097/CRD.0000000000000579

Abstract

Apical hypertrophic cardiomyopathy (ApHCM) represents a rare variant of hypertrophic cardiomyopathy (HCM) with distinct phenotypic characteristics. The prevalence of this variant varies according to each study's geographic region. The leading imaging modality for the diagnosis of ApHCM is echocardiography. Cardiac magnetic resonance, however, is the gold standard for ApHCM diagnosis in case of poor acoustic windows or equivocal echocardiographic findings but also in cases of suspected apical aneurysms. The prognosis of ApHCM was reported to be relatively benign, although more recent studies seem to contradict this, demonstrating similar incidence of adverse events compared with the general HCM population. The aim of this review is to summarize the available evidence for the diagnosis of ApHCM, highlight distinctions in comparison to more frequent forms of HCM with regards to its natural history, prognosis, and management strategies.