[Diastolic murmur in non-obstructive hypertrophic cardiomyopathy]

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Heart Murmurs

Context:

• Non-obstructive hypertrophic cardiomyopathy (non-obst HCM) presents unique diagnostic challenges.
• Diastolic murmurs (DM) are often overlooked or mischaracterized in non-obst HCM.
• Understanding the characteristics and mechanisms of DM is crucial for patient management.

Purpose:

• To investigate the incidence, phonocardiographic features, underlying mechanisms, and clinical associations of diastolic murmurs (DM) in patients with non-obstructive hypertrophic cardiomyopathy (non-obst HCM).
• To determine the clinical utility of auscultatory and phonocardiographic assessment of DM in non-obst HCM patients.

Summary:

• Diastolic murmurs (DM) were identified in 17 of 115 (15%) patients with non-obstructive hypertrophic cardiomyopathy (non-obst HCM), presenting as mid-diastolic, presystolic, or combined types.
• Mechanisms include impaired left ventricular (LV) filling due to reduced LV compliance and decreased diastolic descent rate (DDR), with mitral regurgitation contributing in some cases.
• DM were more prevalent in younger patients with a family history, sudden death, and reduced physical capacity, indicating clinical significance.

Impact:

• Auscultatory and phonocardiographic evaluation of diastolic murmurs provides valuable clinical insights for managing patients with non-obstructive hypertrophic cardiomyopathy.
• This study highlights the importance of detailed cardiac auscultation in the comprehensive assessment of non-obst HCM.
• Findings can guide further research into the hemodynamic consequences and therapeutic targets for diastolic dysfunction in non-obst HCM.