DOI: 10.36347/sjams.2019.v07i02.086

Pages: 826-843

Hypertrophic cardiomyopathy (HCM) is the most common genetically transmitted cardiomyopathy with a long life expectancy in most patients, but with potentially devastating outcomes caused by sudden cardiac death (SCD). The aim of this review was to summarize echocardiographic studies in risk stratification for SCD. PubMed searches were performed by the following search string “hypertrophic cardiomyopathy” and “echocardiography.” The retrieved papers independently screened the records for inclusion and exclusion criteria according to PRISMA guidelines. A total of 841 papers were originally retrieved by searching the database, of which 26 articles were finally included in this systematic review. Ten out of eleven studies showed an association between large left atrium (LA) size and poor outcome or higher risk of arrhythmia. The majority of the studies assessed LA size by measuring LA volume. Significant discrepancies between echocardiography and cardiac magnetic resonance (CMR) were found in four out of six studies comparing left ventricle wall thickness (LVWT) and in two studies comparing LV mass. However, good correlation was seen between real-time 3D echocardiography (RL3DE) and CMR in four studies measuring LVWT and LV mass. Three studies found that systolic dysfunction evaluated by wall motion were predictors of poor outcome, but left-ventricular outflow tract (LVOT) obstruction was not. In conclusion, LA size should be assessed by volume instead of diameter on echocardiography. CMR and RT3DE might be more accurate methods to evaluate LVWT compared to echocardiography. LVOT obstruction as a predictor of outcome is questionable.