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Varieties of right ventricular diastolic function in patients with non-obstructive hypertrophic cardiomyopathy
Kohtaroh Komaki1, Masahito Sakuma, Hidehiko Ishigaki
1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
Insights
The location of left ventricular hypertrophy impacts right ventricular diastolic function in non-obstructive hypertrophic cardiomyopathy. Asymmetric septal hypertrophy impairs diastolic filling more than apical hypertrophy.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
- The impact of hypertrophy location on right ventricular (RV) function in non-obstructive HCM is not fully understood.
Purpose of the Study:
- To investigate if the specific location of myocardial hypertrophy in the left ventricle influences RV diastolic function in patients with non-obstructive HCM.
Main Methods:
- Biplane right ventriculography was performed during cardiac catheterization in 34 subjects.
- Participants were categorized into three groups: normal (n=14), asymmetric septal hypertrophy (n=9), and apical hypertrophy (n=11).
- Key indices of RV diastolic function were analyzed.
Main Results:
- Patients with asymmetric septal hypertrophy showed significantly lower RV peak filling rate and rapid filling fraction, with a prolonged time to peak filling rate compared to normal and apical hypertrophy groups.
- RV diastolic function indices in the apical hypertrophy group were not significantly different from the normal group.
- No significant differences were observed in RV ejection fraction or cardiac index across the three groups.
Conclusions:
- The location of left ventricular myocardial hypertrophy plays a significant role in affecting RV diastolic filling in non-obstructive HCM.
- Asymmetric septal hypertrophy appears to have a more detrimental effect on RV diastolic function compared to apical hypertrophy.
Abstract:
We examined whether differences in the location of myocardial hypertrophy influence the right ventricular diastolic function in patients with non-obstructive hypertrophic cardiomyopathy using cineangiography. Biplane right ventriculography was performed in 34 subjects (normal = 14, asymmetric septal hypertrophy = 9, apical hypertrophy = 11) during cardiac catheterization. In patients with asymmetric septal hypertrophy, compared with apical hypertrophy and normal groups, the indices of the right ventricular diastolic function including right ventricular peak filling rate and filling fraction of rapid filling phase were lower and the time to peak filling rate was prolonged. But in patients with apical hypertrophy, these indices were not significantly different compared with normal. There were no differences in right ventricular ejection fraction and cardiac index among the three groups. These data suggest that the location of the myocardial hypertrophy of the left ventricle is a significant factor affecting the right ventricular diastolic filling in non-obstructive hypertrophic cardiomyopathy.