Right ventricular function declines prior to left ventricular ejection fraction in hypertrophic cardiomyopathy

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Cardiac MRI

Background:

• Hypertrophic cardiomyopathy (HCM) research often overlooks right ventricular (RV) abnormalities.
• Focus has predominantly been on left ventricular (LV) dysfunction in HCM prognosis.

Purpose of the Study:

• To evaluate RV function in HCM patients.
• To assess temporal changes in RV function.
• To determine the association between RV dysfunction and clinical outcomes.

Main Methods:

• Cardiovascular magnetic resonance (CMR) was used in 290 HCM patients and 30 controls.
• Baseline and follow-up CMR assessed RV ejection fraction (RVEF) and RV strain.
• Clinical events were tracked for a median of 4.4 years.

Main Results:

• HCM patients showed reduced RV and LV systolic strains compared to controls.
• RV and LV strain parameters decreased over time; RVEF significantly declined.
• Reduced RVEF independently predicted non-sustained ventricular tachycardia and composite cardiovascular events.

Conclusions:

• RV function, including RV strain, declines over time in HCM, independent of LVEF.
• Deterioration in RV function, not LV function, is linked to adverse cardiovascular outcomes.
• RV function assessment in early HCM may aid in risk stratification and event prevention.