11
6.2. Echocardiography
COR LOE
Recommendations
1 B-NR
6. For patients with HCM who are undergoing surgical septal
myectomy, intraoperative transesophageal echocardiogram
(TEE) is recommended to assess mitral valve anatomy and
function and adequacy of septal myectomy.
1 B-NR
7. For patients with HCM who are undergoing alcohol septal
ablation, TTE or intraoperative TEE with intracoronary
ultrasound-enhancing contrast injection of the candidate's
septal perforator(s) is recommended.
1 B-NR
8. For patients with HCM who have undergone SRT, TTE
within 3 to 6 months after the procedure is recommended to
evaluate the procedural results.
1 B-NR
9. Screening : In first-degree relatives of patients with HCM, a
TTE is recommended as part of initial family screening and
periodic follow-up (Figure 1, Table 6).
1 B-NR
10. Screening : In individuals who are genotype-positive,
phenotype-negative, echocardiography is recommended at
periodic intervals depending on age (1 to 2 years in children
and adolescents, 3 to 5 years in adults) and change in clinical
status (Figure 1, Table 6).
2a C-LD
11. For patients with HCM, TEE can be useful if TTE is
inconclusive in clinical decision-making regarding medical
therapy, and in situations such as planning for myectomy,
exclusion of subaortic membrane or MR secondary to
structural abnormalities of the mitral valve apparatus, or in
the assessment of the feasibility of alcohol septal ablation.
2a B-NR
12. For patients with HCM in whom the diagnosis of apical
HCM, apical aneurysm, or atypical patterns of hypertrophy
is inconclusive on TTE, the use of an intravenous ultrasound-
enhancing agent is reasonable, particularly if other imaging
modalities such as CMR are not readily available or are
contraindicated.
2a C-LD
13. For asymptomatic patients with HCM who do not have a
resting or provocable outflow tract peak gradient ≥50 mm
Hg on standard TTE, exercise TTE is reasonable for the
detection and quantification of dynamic LVOTO.
(cont'd)
