How does morphology impact on diastolic function in hypertrophic cardiomyopathy? A single centre experience

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Heart Failure Research

Background:

• Hypertrophic cardiomyopathy (HCM) is a complex condition affecting heart muscle structure.
• The impact of specific HCM morphologies on diastolic function remains incompletely understood.
• Diastolic dysfunction is a common complication in HCM, affecting patient prognosis.

Purpose of the Study:

• To investigate the relationship between diverse HCM morphologies and diastolic function parameters.
• To identify key clinical and echocardiographic correlates of diastolic dysfunction in a large HCM cohort.
• To determine if specific HCM patterns are associated with more severe diastolic impairment.

Main Methods:

• Retrospective analysis of 383 HCM patients with preserved systolic function.
• Classification of HCM morphology into predefined categories (reverse, sigmoid, symmetric, apical, undefined).
• Comprehensive echocardiographic assessment of diastolic function (E', E/E', indexed left atrial volume) compared to 100 healthy controls.

Main Results:

• No significant differences in diastolic dysfunction parameters (E', E/E', LAVi) were observed among different HCM morphologies.
• All HCM morphologies demonstrated impaired diastolic function compared to controls.
• Left ventricular (LV) obstruction was a significant independent predictor of diastolic dysfunction, particularly elevated LAVi, E/E', and reduced E'.

Conclusions:

• Diastolic dysfunction in HCM is prevalent across all morphological types and not significantly influenced by the specific pattern.
• Key independent predictors of diastolic dysfunction include LV obstruction, patient age, LV wall thickness, and mitral regurgitation severity.
• These findings highlight the importance of addressing LV obstruction and other contributing factors to manage diastolic dysfunction in HCM.