ASECHO Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy Guideline Summary

Cardiac Amyloidosis versus HCM

Echocardiography is the initial imaging modality for evaluation of the presence, magnitude, and pattern of LV hypertrophy and UEA should be used whenever needed.
CMR is indicated in patients with suboptimal echocardiographic images, and patients with borderline LV hypertrophy.
If CMR is contraindicated or could not be performed, cardiac CT is considered next.
Irrespective of which imaging modality is used, the report should comment on the pattern and extent of LV hypertrophy including maximum wall thickness.

Assessment of LVEF should be performed in all HCM patients using echocardiography, with or without UEA, at the time of diagnosis and when there is a significant change in clinical condition. There should be a low threshold for using imaging modalities such as CMR or CT for LV systolic function assessment when echocardiographic images are suboptimal.
Assessment of global longitudinal strain adds important prognostic data and may be performed in centers with experience and expertise with using strain echocardiography.

Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy