• Romain Martin, Olivier Lairez, Nicolas Boudou, Simon Méjean, Thibault Lhermusier, Nicolas Dumonteil, Matthieu Berry, Thomas Cognet, Pierre Massabuau, Meyer Elbaz, Hervé Rousseau, Michel Galinier, and Didier Carrié.
• Department of Cardiology, Rangueil University Hospital, 1, avenue Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France; Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.
• Arch Cardiovasc Dis. 2013 Aug 1;106(8-9):440-7.

BackgroundHypertrophic cardiomyopathies (HCM) are often associated with left ventricular (LV) outflow tract obstruction, which can explain symptoms and impact prognosis.AimsTo better understand the mechanisms that link obstruction and LV shape in HCM.MethodsPatients with HCM who underwent cardiac magnetic resonance (CMR) imaging were included retrospectively. Obstructive HCM was defined as LV outflow gradient more than 30 mm Hg at rest by transthoracic echocardiography. The LV shape and mitral angle were assessed by CMR. Results were compared with control subjects.ResultsMean LV-mitral angle was smaller in patients with obstructive HCM (n=29) than in patients with non-obstructive HCM (n=15) or control subjects (n=15) (80 ± 5° vs 87 ± 7° [P=0.0002] and 89 ± 2° [P<0.0001]). Mean mitral papillary muscles angle was greater in patients with non-obstructive HCM than in patients with obstructive HCM or control subjects (136 ± 17° vs 123 ± 16° [P=0.007] and 118 ± 10° [P=0.002]). Patients with non-obstructive HCM had a greater mean LV-aortic root angle than patients with obstructive HCM or control subjects (139 ± 6° vs 135 ± 7° [P=0.04] and 133 ± 7° [P=0.03]).ConclusionThere is a relation between morphological and functional parameters in HCM within which the mitral valve is probably part of pathophysiogenesis.Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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