Right ventricular diastolic function in patients with hypertrophic cardiomyopathy--an invasive study

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Biventricular Assessment of Cardiac Function and Pressure-Volume Loops by Closed-Chest Catheterization in Mice

Published on: June 15, 2020

M Maeda1, T Yamakado, T Nakano

  • 1The First Department of Internal Medicine, Mie University, Japan.

Japanese Circulation Journal
|September 25, 1999
PubMed

Insights

Right ventricle diastolic dysfunction is common in hypertrophic cardiomyopathy (HCM) patients, showing impaired relaxation and delayed filling. These findings highlight the need for assessing right ventricular diastolic function in HCM.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart disease primarily affecting the left ventricle.
  • Right ventricular (RV) diastolic function in HCM is not well understood.
  • Assessing RV diastolic function is crucial for a comprehensive understanding of HCM pathophysiology.

Purpose of the Study:

  • To evaluate right ventricle (RV) diastolic function in patients with hypertrophic cardiomyopathy (HCM).
  • To characterize abnormalities in RV relaxation and filling dynamics in HCM.

Main Methods:

  • Biplane RV angiograms and RV pressures were analyzed in 19 HCM patients and 13 controls.
  • Ventricular relaxation assessed by time constant of isovolumic pressure decay (T).
  • Diastolic filling parameters included peak filling rate (PFR), time to PFR (TPFR), and % atrial contribution (%AF).

Main Results:

  • RV isovolumic relaxation time constant (T) was significantly prolonged in HCM patients.
  • Time to peak filling rate (TPFR) was significantly greater in HCM patients, indicating delayed diastolic filling.
  • RV diastolic pressure-volume relations were shifted upward, suggesting decreased diastolic distensibility.

Conclusions:

  • Patients with HCM exhibit impaired isovolumic relaxation of the right ventricle.
  • Delayed diastolic filling and reduced diastolic distensibility are characteristic of RV dysfunction in HCM.
  • These findings underscore the importance of evaluating RV diastolic function in the management of HCM.

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