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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Updated: Jun 19, 2026

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
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Invasive exercise hemodynamics in obstructive and non-obstructive hypertrophic cardiomyopathy.

Claudia Baratto1,2, Sergio Caravita2,3, Giovanni Battista Perego1

  • 1Department of Cardiology, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milano, Italy.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|June 18, 2026
PubMed
Summary
This summary is machine-generated.

Hypertrophic cardiomyopathy (HCM) patients show different exercise responses. Non-obstructive HCM may have increased left atrial pressure, while obstructive HCM can see reduced outflow tract obstruction during exercise.

Keywords:
cardiac catheterizationexercisehemodynamicshypertrophic cardiomyopathypulmonary hypertension

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Published on: September 22, 2023

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Heart Disease Research

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex heart condition.
  • HCM can cause shortness of breath due to left ventricular outflow tract obstruction (LVOTO), diastolic dysfunction, or left atrial issues.
  • Understanding how these factors affect exercise capacity is crucial for patient management.

Purpose of the Study:

  • To investigate the hemodynamic changes during exercise in patients with HCM.
  • To differentiate the exercise responses between obstructive and non-obstructive HCM.
  • To determine the contribution of LVOTO, diastolic dysfunction, and left atrial function to exercise limitations in HCM.

Main Methods:

  • Conducted rest and exercise cardiac catheterization in 25 HCM patients.
  • Classified patients into non-obstructive (no-HOCM) and obstructive (HOCM) groups.
  • Overt HOCM had resting LVOTO > 30 mmHg; latent HOCM had exercise-induced LVOTO ≥ 50 mmHg.

Main Results:

  • No significant difference in resting pressures (LV end-diastolic, PAWP, PAWP V waves) between groups.
  • During exercise, non-obstructive HCM showed a greater increase in pulmonary artery wedge pressure (PAWP) and PAWP V waves (indicating left atrial stiffness).
  • Overt obstructive HCM experienced a reduction in LVOTO during supine exercise.

Conclusions:

  • Non-obstructive HCM patients may exhibit greater increases in left atrial pressure during exercise, suggesting more significant left atrial myopathy or reduced compliance.
  • Obstructive HCM patients with overt obstruction may show a paradoxical decrease in LVOTO during supine exercise.
  • These findings highlight distinct pathophysiological mechanisms contributing to exercise intolerance in different HCM subtypes.