Unclassified Cardiomyopathies

The Role of Cardiovascular Magnetic Resonance Imaging in Heart Failure

Heart failure (HF) can be defined haemodynamically as any abnormality of cardiac structure or function resulting in a failure to deliver oxygen at a rate adequate for tissue requirements, despite normal filling pressures – or only at the expense of increased filling pressures.1 Around half of patients with HF have reduced left ventricle ejection fraction (LVEF; EF <40 %) at rest (HF-REF).2

Assessment of Left Ventricular Diastolic Function by Doppler Echocardiography

Diastole is an important period in the cardiac cycle when all heart components integrate together to secure optimum ventricular filling which determines the stroke volume pumped by the ventricle in the succeeding cycle. Three diastolic phases are well-recognised; early diastole, diastasis and late diastole ‘atrial systole’ (Figure 1). To describe the actual events happening in the ventricle the three phases are named; early filling, diastasis and late filling.

Alcohol Septal Ablation for the Treatment of Hypertrophic Obstructive Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a genetic disorder of cardiac muscle with a heterogeneous clinical course.1 The disease is clinically characterised by left ventricular hypertrophy (LVH), which is typically asymmetric, and a subgroup of patients have left ventricular outflow tract obstruction (LVOTO) caused by systolic anterior motion (SAM) of the mitral valve leaflet(s).2,3 LVOTO is often associated with limiting cardiovascular symptoms and a worse prognosis.4–8

Left Ventricular Non-compaction Cardiomyopathy

In this article, we describe three cases of heart failure that did not fit the general categories of cardiomyopathy (CM), namely dilated, hypertrophic, non-dilated, non-hypertrophic types. The salient feature was non-compaction of the left ventricular (LV) myocardium on 2D echocardiography (2DE).

The normal LV myocardium is compact with scarce, inconspicuous, or no trabeculation. Trabeculae are muscular bands of the endocardium separated by spaces. The intertrabecular spaces are normally shallow or not prominent.

Left Ventricular Non-compaction - When Are Trabeculations Excessive?

A 55-year-old man was referred for evaluation of heart failure. He had been well until three years prior, when he began developing exercise intolerance and atrial arrhythmias. He was admitted for decompensated heart failure and an echocardiogram showed an ejection fraction of 30%. Cardiac catheterization showed non-obstructive coronary artery disease (CAD). His medical therapy was optimized and an implantable cardioverter–defibrillator (ICD) was placed for primary prevention of sudden cardiac death.