Scanning the imaging horizon for hypertrophic cardiomyopathy.

This paper discusses some of the recent advances in the use of noninvasive imaging applied to patients with hypertrophic cardiomyopathy. Echocardiography and cardiac CT are briefly discussed with respect to their power to detect apical aneurysmal disease. Echo phenotype-genotype correlations and the ability of echo to characterize myocardial work are reviewed. Positron emission tomography (PET) is reviewed in the context of ischaemia imaging and also the use of a new tracer which may allow for recognition of early activation of the fibrosis pathway. Next, the technical capabilities of CMR to measure myocardial perfusion, oxygenation and disarray are discussed as they apply to HCM. The application of radiomics to improve prediction of sudden cardiac death is touched upon. Finally, a deep learning approach to the recognition of HCM versus phenocopies is presented as a potential future diagnostic aid in the not-too-distant future.