Short-term effect of repeat echocardiographic screening for detection or confirmation of hypertrophic cardiomyopathy
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Background
Diagnosis of Hypertrophic Cardiomyopathy (HCM) can be challenging. HCM can present later in life and the value of repeat echocardiogram for late presentation of HCM is not known. The goal of this study was to evaluate any changes in wall thickness occurring within 2 years using repeat screening echocardiography.
Method
The Anthony Bates Foundation has been performing screening echocardiography in high schools across the United States for the prevention of sudden death since 2001. A total of 206 subjects underwent baseline and repeat echocardiography within 2 years. We evaluated the prevalence of HCM before and after repeated echocardiography. Suspected HCM was defined as any wall thickness > 15 mm.
Results
The total prevalence of suspected HCM, defined by a cut-off value of 15 mm or more, was two from 206 (0.9%). Repeat echo within one year found one additional case of suspected HCM (wall thickness changed from 14 to 15 mm). However, the other two initial cases of suspected HCM showed regression of wall thickness to <15 mm not qualifying as HCM anymore as previously suspected after 2 years (one decreased wall thickness from 15 to 12 and the other one from 15 to 13 mm)
Conclusion
We found that repeat echocardiography is warranted in subjects with suspected HCM in order to prevent overdiagnosis. Furthermore, a new diagnosis of suspected cardiomyopathy was detected within 2 years of repeat screening. Larger studies are needed to evaluate the best timing and frequency of screening echocardiography for the detection and prevention of HCM.
