The Clinical Value of MRI in Evaluating Apical Hypertrophic Cardiomyopathy

SONG Xiaojing; LI Shuangzhan; YANG Xiuqing

doi:10.12102/j.issn.1672-1349.2025.18.019

Abstract：Objective: To explore the value of magnetic resonance imaging (MRI) in the assessment of apical hypertrophic cardiomyopathy (AHCM). Methods: A total of 79 patients suspected of AHCM who underwent relevant examinations at our hospital from June 2020 to June 2022 were selected. All patients received two-dimensional ultrasound and MRI examinations. Clinical manifestations, medical history, and two-dimensional ultrasound findings were used as the 'gold standard' for diagnosing AHCM, and the diagnostic efficiency of MRI was evaluated. According to the diagnosis results, patients were divided into AHCM group and non-AHCM group. The AHCM group was further classified into early AHCM group and typical AHCM group based on severity. Differences in MRI quantitative analysis parameters [left ventricular apex wall thickness/end-diastolic left ventricular posterior wall thickness ratio (LVA/LVPW), left ventricular wall thickening rate (LVAT)] between different groups were compared, and the diagnostic evaluation efficiency of these parameters for AHCM and its severity was analyzed. Results: Among the 79 patients suspected of AHCM, 52 were diagnosed with AHCM by two-dimensional ultrasound, clinical symptoms, and medical history, including 16 typical AHCM cases and 36 early AHCM cases. The sensitivity and specificity of MRI in diagnosing AHCM were 98.07% and 92.59%, respectively. The LVA/LVPW in the AHCM group was higher than that in the non-AHCM group (P < 0.05), while LVAT was lower, with statistically significant differences (P < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the areas under the curve (AUC) for LVA/LVPW and LVAT in diagnosing AHCM were 0.880 and 0.854, respectively, with optimal cutoff values of 1.66 and 59.28%, indicating good diagnostic performance (P < 0.05). The LVA/LVPW in the typical AHCM group was higher than that in the early AHCM group, while LVAT was lower, with statistically significant differences (P < 0.001). ROC curve analysis showed that the AUC for LVA/LVPW and LVAT in assessing the severity of AHCM were 0.774 and 0.801, respectively, with optimal cutoff values of 1.82 and 46.02%, indicating good evaluation performance (P < 0.05). Conclusion: In the diagnosis of AHCM, MRI can accurately display the thickness of each myocardial wall, and some quantitative parameters can reflect the structure and movement of the apical region.