Non-Echocardiographic Evaluation of Hypertrophic Cardiomyopathy
6 affiliations
- 1Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA
- 2Department of Internal Medicine, Crestwood Medical Center, Huntsville, AL 35801, USA
- 3Department of Critical Care, Faculty of Medicine, Ain Shams University, 1181 Cairo, Egypt
- 4Department of Internal Medicine, Zucker School of Medicine at Hofstra/Northwell, Danbury, CT 06810, USA
- 5Neuroscience Department, Case Western Reserve University, Cleveland, OH 44106, USA
- 6Alaska Heart and Vascular Institute, University of Alaska, Anchorage, AK 99571, USA
Abstract
Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic and phenotypic myocardial disease where diagnosis and risk stratification extend beyond the mere detection of left ventricular hypertrophy. While echocardiography is the first-line imaging modality, this approach often offers limited insights into disease etiology, biological activity, and natural history. Thus, several non-echocardiographic modalities have emerged as prominent components of contemporary HCM investigations. Electrocardiography (ECG) provides early, readily accessible insights into myocardial remodeling and arrhythmic risk. Cardiac magnetic resonance (CMR) imaging enhances phenotyping through detailed tissue characterization and fibrosis assessment, while nuclear imaging uniquely evaluates myocardial perfusion and microvascular injury. Plasma biomarkers and genetic testing offer valuable insights into disease activity and risk stratification for affected individuals and at-risk relatives, especially when combined with imaging findings. Therefore, this review summarizes current knowledge on non-echocardiographic approaches to HCM, highlighting the associated complementary strengths and the value of integrated multimodality assessment in improving disease phenotyping, prognostication, and management. Importantly, integrating these modalities improves risk stratification for sudden cardiac death, heart failure progression, and arrhythmias, guiding decisions on implantable cardioverter-defibrillator (ICD) placement and medical management. This approach supports more personalized, mechanism-based care in HCM.
Related
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BibTeX
@article{ali2026nonechocardiographic,
title = {{Non-Echocardiographic Evaluation of Hypertrophic Cardiomyopathy}},
author = {Karim Ali and Ahmed E. Ali and Mohamed K. Awad and Kyle Wansing and Mohamad Elgozair and Mohamed Abdalla and Cooper Gearhart and Ahmed Sami Abuzaid},
journal = {Reviews in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.31083/rcm51298},
url = {https://doi.org/10.31083/rcm51298},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Non-Echocardiographic Evaluation of Hypertrophic Cardiomyopathy
AU - Karim Ali
AU - Ahmed E. Ali
AU - Mohamed K. Awad
AU - Kyle Wansing
AU - Mohamad Elgozair
AU - Mohamed Abdalla
AU - Cooper Gearhart
AU - Ahmed Sami Abuzaid
PY - 2026
DA - 2026/10/12
JO - Reviews in Cardiovascular Medicine
DO - 10.31083/rcm51298
UR - https://doi.org/10.31083/rcm51298
AB - Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic and phenotypic myocardial disease where diagnosis and risk stratification extend beyond the mere detection of left ventricular hypertrophy. While echocardiography is the first-line imaging modality, this approach often offers limited insights into disease etiology, biological activity, and natural history. Thus, several non-echocardiographic modalities have emerged as prominent components of contemporary HCM investigations. Electrocardiography (ECG) provides early, readily accessible insights into myocardial remodeling and arrhythmic risk. Cardiac magnetic resonance (CMR) imaging enhances phenotyping through detailed tissue characterization and fibrosis assessment, while nuclear imaging uniquely evaluates myocardial perfusion and microvascular injury. Plasma biomarkers and genetic testing offer valuable insights into disease activity and risk stratification for affected individuals and at-risk relatives, especially when combined with imaging findings. Therefore, this review summarizes current knowledge on non-echocardiographic approaches to HCM, highlighting the associated complementary strengths and the value of integrated multimodality assessment in improving disease phenotyping, prognostication, and management. Importantly, integrating these modalities improves risk stratification for sudden cardiac death, heart failure progression, and arrhythmias, guiding decisions on implantable cardioverter-defibrillator (ICD) placement and medical management. This approach supports more personalized, mechanism-based care in HCM.
SN - 1530-6550
SN - 2153-8174
ER -