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[Diastolic dysfunction in hypertrophic nonobstructive cardiomyopathy]
Insights
In hypertrophic nonobstructive cardiomyopathy (NHCM), diastolic dysfunction is common, primarily of the hypertrophic type. This dysfunction, along with impaired contractility, contributes to heart failure symptoms and syncope.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Cardiac Imaging
Context:
- Hypertrophic nonobstructive cardiomyopathy (NHCM) is a complex condition.
- Understanding left ventricular (LV) diastolic dysfunction is crucial in NHCM management.
- Doppler echocardiography is a key diagnostic tool.
Purpose:
- To evaluate the prevalence and types of LV diastolic dysfunction in NHCM patients.
- To correlate diastolic dysfunction with clinical manifestations and cardiac structure.
- To identify associated contractile dysfunction in NHCM.
Summary:
- 83% of 97 NHCM patients exhibited LV diastolic dysfunction, predominantly hypertrophic type.
- Diastolic dysfunction correlated with NYHA class III heart failure and syncope.
- Both left and right ventricular hypertrophy severity influenced diastolic dysfunction; 94% had impaired contractility.
Impact:
- Highlights the high prevalence of diastolic dysfunction in NHCM.
- Emphasizes the link between diastolic dysfunction, clinical symptoms, and biventricular hypertrophy.
- Underscores the frequent co-occurrence of diastolic and contractile dysfunction in NHCM.
Objective:
The purpose of research was to assess the availability and prevalence of types of diastolic dysfunction of the left ventricle (LV) in hypertrophic nonobstructive cardiomyopathy (NHCM).
Methods:
97 NHCM patients. Mean age 42.5 ± 14.9 years. Diastolic dysfunction assessed by Doppler echocardiography.
Results:
Signs of chronic heart failure NYHA class I observed in 44 (45%) patients, class II--in 40 (41%), class II--in 13 (13%) patients. 83% patients had LVdiastolic dysfunction, mainly on the hypertrophic type. One third of the patients had pseudonormal type with uncertain interpretation. Diastolic dysfunction in terms of clinical manifestations determined mainly NYHA class III and syncope. Severity of LV diastolic dysfunction in NHCM depended on the severity of hypertrophy not only left, but the right ventricle too. In 94% of cases we observed not only diastolic dysfunction, but also reduction ofsecondary fibers shortening fraction--as sign of contractile dysfunction.
Conclusion:
Thus, in NHCM dominated diastolic dysfunction of hypertrophic type. Such dysfunction defining a clinic cardiac deficiency or syncope. One third of the patients had pseudonormal transmitral flow type, difficult to assess diastolic function. Diastolic dysfunction in NHCM was combined with impaired contractility of the walls of ventricle.
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