Apical morphology and dynamics analysis in hypertension and apical hypertrophic cardiomyopathy: new insights on the role of echocardiography

Abstract Background: The objective of this study was to introduce several novel indices to evaluate the apical morphological and dynamical features of apical hypertrophic cardiomyopathy (AHCM) and hypertensive patients using echocardiography. Methods: A total of 125 selected subjects underwent echocardiography imaging, 35 patients with AHCM, 45 patients with essential hypertension and 45 healthy controls. The apical morphological and dynamic features included apical-basal wall thickness ratio (ABR, maximal apical wall thickness / posterior basal wall thickness), apical angle (apA), peak blood flow velocity at the apical cavity (Vap) and its ratio to the velocity at left ventricular outflow tract (Vap/ Vlvot), and, relative apical longitudinal strain [RALS, RALS = apical longitudinal strain (LSapical)/ sum of basal and mid LS (LSbasal +LSmiddle)]. Results: Patients with hypertension had lower apA, higher Vap compared to healthy controls (p < 0.001 for all). However, ABR, Vap/ Vlvot, RALS between the 2 groups showed no statistically difference. Compared to healthy controls and hypertensives, AHCM had significantly higher ABR, Vap/ Vlvot, and lower apA, RALS (p < 0.001 for all). Conclusion: Echocardiography is a valuable and promising tool to assess the apical morphology and dynamics. ABR, apA, Vap/ Vlvot, RALS arrived from echocardiography can be used to distinguish between hypertension and AHCM.