Key result
Multimodal imaging-guided revascularization cuts NT-proBNP ~75% and improves LVEF in a non-obstructive HCM case.
Why the study?
HCM features diverse phenotypic and genetic expressions leading to significant complications, highlighting the need to illustrate multimodal imaging's role in management.
Case Report (n=1)
No
Multimodal imaging, particularly CMR with LGE, is crucial in complex HCM cases to assess myocardial viability and fibrosis, directly guiding interventions like revascularization and ICD placement.
Answers are grounded in this paper and cite their sources.
Multimodal imaging may guide revascularization and ICD decisions in non-obstructive HCM with aneurysm; leaves open prospective validation in larger cohorts.
Hypertrophic cardiomyopathy (HCM) is a prevalent inherited cardiac disorder characterized by diverse phenotypic and genetic expressions, leading to significant clinical complications and increased cardiovascular risk 1 . This case focuses on the problematic progression of a 50-year-old woman with non-obstructive HCM and acquired cardiovascular risk factors, culminating in severe systolic dysfunction and the development of an apical aneurysm. Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) revealed severe left ventricular (LV) systolic dysfunction, alongside significant myocardial fibrosis and viability, which guided prognostic therapeutic decisions, including myocardial revascularization and prophylactic implantable cardioverter-defibrillator (ICD) placement. This case illustrates the importance of using multimodal imaging in managing HCM.
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Bărboi et al. (2026) conducted a case report in 50-year-old female with non-obstructive hypertrophic cardiomyopathy, severe left ventricular systolic dysfunction (LVEF 25-36%), apical aneurysm, and acquired cardiovascular risk factors (n=1). Multimodal imaging guided management including myocardial revascularization with drug-eluting stent and implantable cardioverter-defibrillator (ICD) placement was evaluated on Improvement in NT-proBNP levels and left ventricular ejection fraction after myocardial revascularization and medical therapy optimization. Myocardial revascularization and ICD placement guided by multimodal imaging improved NT-proBNP from 8833 to 2200 pg/mL and increased LVEF from 25% to 36% in a 50-year-old woman with non-obstructive HCM and apical aneurysm.
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