ESC reviews on multimodality cardiac imaging

The European Society of Cardiology has recently published two reviews on cardiac imaging, chaired and co-chaired by HeartGenetics advisory board member Dr. Nuno Cardim, which intend to acquaint physicians with the power of multimodality imaging in the assessment of athletes’ cardiac performance and management of patients with hypertrophic cardiomyopathy. These reviews also discuss the role of genetics in …

… cardiovascular response to exercise
“Cardiac response to training is also influenced by additional factors including hormonal stimuli and genetic susceptibility”

… uncovering the causes of sudden cardiac death (SCD)
“More widespread use of genetic analysis following autopsies now allows to reveal previously undiscovered causes of SCD at ordinary autopsies.”

… the prodisposition to cardiovascular disease in athletes
“A possible effect of exercise in accelerating the development of ARVC in athletes who are genetically predisposed should also be taken into account”

… changes in left ventricular thickness
“(…) a reduction of LV wall thickness may be observed in physiological LVH but also in athletes with HCM, reflecting the complex interaction between genetic and environmental factors.”

… the diagnosis of cardiovascular disease in athletes
“Cardiac imaging is important in identifying cardiovascular disease in athletes, but the final diagnosis has to be based on multiple factors including medical history, sports history, training load, symptoms, age, gender, ECG (resting and exercise), or genetic analysis.”

Screenshot from 2015-05-04 15:08:13 — **Figure 1:** Diagnosis of HCM by cardiac magnetic resonance imaging in a 41-year old endurance athlete. (A) Enlarged left ventricule, (B-D) Myocardial fibrosis of anterior and inferior septum revelaed by LGE. **Diagnosis confirmed by genetic testing**. Adapted from ref 1.

and how IVS morphology has also been correlated with the probability of a positive genetic test for sarcomeric mutations:

IVS morphology	Probability of a positive genetic test for sarcomeric mutations
Reverse IVS	High
Apical or neutral IVS	Moderate
‘Sigmoid’ IVS	Low

For further reading please consult the original articles from the European Heart Journal – Cardiovascular Imaging.

References:

[1] Galderisi M, Cardim N, et al. Eur Heart J Cardiovasc Imaging. 2015 Feb 13. [Epub ahead of print] PubMed PMID: 25681828.

[2] Cardim N, Galderisi M, et al. Eur Heart J Cardiovasc Imaging. 2015 Mar;16(3):280. PubMed PMID: 25650407.