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Longitudinal changes in left ventricular diastolic function in hypertrophic cardiomyopathy
Insights
Left ventricular diastolic function in hypertrophic cardiomyopathy patients remained stable over three years. Some individuals showed spontaneous improvements in relaxation, mimicking therapeutic effects.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition.
- Diastolic dysfunction is a key feature of HCM.
- Longitudinal changes in diastolic function in HCM are not well understood.
Purpose of the Study:
- To investigate the 3-year changes in left ventricular diastolic function in patients with hypertrophic cardiomyopathy.
- To compare diastolic function changes in HCM patients with healthy controls.
Main Methods:
- Digitized M-mode echocardiography was employed.
- Evaluated 11 patients with HCM and 14 healthy controls.
- Assessed parameters including isovolumic relaxation time and mitral valve opening delay.
Main Results:
- HCM patients exhibited prolonged isovolumic relaxation and delayed mitral valve opening compared to normals.
- No significant mean functional changes were observed over the 3.4-year follow-up period.
- Three patients demonstrated marked improvements in diastolic function, with reduced relaxation delays.
Conclusions:
- Left ventricular diastolic function in most HCM patients is stable over a 3-year period.
- No apparent deterioration in diastolic function was noted in the study cohort.
- Spontaneous functional improvements can occur in some HCM patients, comparable to therapeutic interventions.
Abstract:
Digitised M-mode echocardiography was used to study the changes in left ventricular diastolic function over a 3-year period in 11 patients with hypertrophic cardiomyopathy an 14 normals. Compared to normal, in hypertrophic cardiomyopathy, isovolumic relaxation was prolonged (P less than 0.001) and mitral valve opening delayed relative to minimum dimension (P less than 0.001). There was a wide range of values for the peak rates of dimension increase and wall thinning, and although the means were normal, 6 and 8 patients respectively were outside the normal range. There were no significant mean changes in function during the 3.4 +/- 0.3 years of follow-up, but, in 3 patients, marked alterations in relaxation were observed. They showed a gross reduction in the delay in mitral valve opening (125 to 55 125 to 35 and 110 to 75 msec). There was little overall change in isovolumic relaxation in two, but in one patient it reduced from 95 to 50 msec. In most patients with hypertrophic cardiomyopathy, relaxation and diastolic function appear to remain stable over a period of 3 years, and none had an apparent deterioration. Some patients may have an apparently spontaneous "improvement" in function similar in extent to that described due to the therapeutic action of calcium antagonists.