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Education in Heart
Utility of echocardiography in the evaluation of individuals with cardiomyopathy
  1. Malissa J Wood,
  2. Michael H Picard
  1. Cardiac Ultrasound Laboratory, Cardiology Division and Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to:
    Malissa J Wood MD
    Cardiac Ultrasound Laboratory VBK 508, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; mjwoodpartners.org

https://doi.org/10.1136/hrt.2003.024778

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    Cardiomyopathies and their resultant systolic and diastolic heart failure remain a major cause of cardiovascular morbidity and mortality. The prevalence of heart failure continues to increase and it remains a major public health threat, particularly in the elderly.1 The overall annual healthcare expenditure for heart failure continues to increase. While a new diagnosis of heart failure is associated with substantial risk of death within one year, the institution of appropriately guided pharmacologic treatment has led to substantial reductions in cardiovascular mortality.2 Identification of potential candidates for such treatment can be facilitated through use of echocardiography.

    In many patients the diagnosis of a cardiomyopathy is made after the onset of heart failure symptoms, atrial or ventricular arrhythmias, or a stroke. These complications of the underlying cardiomyopathy represent major causes of cardiovascular morbidity and mortality and frequently result in referral for echocardiography. Echocardiography provides an assessment of systolic and diastolic function as well as an estimation of left and right heart filling pressures. In addition, specific echocardiographic features allow the clinician to determine more accurately the aetiology of the cardiomyopathy. Integration of clinical and echocardiographic features now allows for a better assessment of both immediate risk and long term prognosis in patients with a cardiomyopathy.

    DEFINITION AND CLASSIFICATION OF CARDIOMYOPATHIES

    Cardiomyopathies are defined by the World Health Organization as diseases of the myocardium which result in cardiac dysfunction. The WHO classification of cardiomyopathies includes: hypertrophic, dilated, restrictive, and arrhythmogenic right ventricular cardiomyopathies.3 Although isolated non-compaction of the ventricular myocardium has not yet been identified as a distinct cardiomyopathy by WHO, it will also be discussed in this review. It is a rare but important cardiomyopathy with distinctive echocardiographic features. The echocardiographic features of specific cardiomyopathies are presented in table 1.

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    Table 1

    Two dimensional echocardiographic features of cardiomyopathies

    The distinguishing features of the various forms of …

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      Heart 2004; 90 938-938 Published Online First: 14 Jul 2004.