The Role of the Submitral Apparatus in Hypertrophic Obstructive Cardiomyopathy

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease, is characterized by unexplained hypertrophy of any myocardial segment, and has a prevalence of 0.2% to 0.5% among the general population. As one of the phenotypes of HCM, left ventricular outflow tract obstruction (LVOTO) is associated with high morbidity and mortality, including cardiac death. The integration of various factors, including septal hypertrophy, malformation of the mitral valve apparatus, and an anomalous mitral subvalvular apparatus, may contribute to the occurrence of LVOTO. Previous studies have thoroughly discussed the role of the mitral valve in the mechanisms of systolic anterior motion (SAM) and LVOTO. Recent studies have shown the importance of determining the potential mechanism of the submitral apparatus in inducing SAM and LVOTO. We aim to review the recent advances in knowledge regarding the submitral apparatus of HCM patients.