Hypercontractile phenotype in hypertrophic cardiomyopathy indicates unfavorable hemodynamics, coronary flow and prognosis
No Thumbnail Available
Authors
Wierzbowska-Drabik,Karina;Pálinkás,Eszter Dalma;D'Alfonso,Maria Grazia;Mori,Fabio;Del Franco,Annamaria;Vazquez,Jesus Peteiro;Re,Federica;Tesic,Milorad;Djordjevic-Dikic,Ana;Pálinkás,Attila;Rosa,Silvia Aguiar;Losi,Maria Angela;Rodriguez-Zanella,Hugo;Cruz,Ines;Lopes,Luis Rocha;Nemes,Attila;Arruda-Olson,Adelaide;Wang,Yi;Yin,Lixue;Tripepi,Giovanni L.;Broncel,Marlena;Bartolacelli,Ylenia;Pepi,Mauro;Carerj,Scipione;Ciampi,Quirino;Pellikka,Patricia;Olivotto,Iacopo;Picano,Eugenio
Check for full-text access
Issue Date
2025
Type
Article
Language
Keywords
Alternative Title
Abstract
AIMS: Our aim was to assess the clinical and prognostic significance of the left ventricular (LV) hypercontractile phenotype (HP) in hypertrophic cardiomyopathy (HCM), which until now remains unclear. METHODS AND RESULTS: We enrolled 1533 HCM patients (age 51 ± 15 years, 965 males, 63%) with ejection fraction (EF) ≥ 50%, referred for rest transthoracic echocardiography (TTE) in 27 laboratories from 13 countries. Two-dimensional volumetric TTE assessment included LV outflow tract gradient (LVOTG), LV EF, and LV force (systolic blood pressure + LVOTG/ESV, mmHg/mL). HP was defined as the highest quartile of the force (> 7.32 mmHg/mL). Survival analysis was performed in a subset of 1200 patients with follow-up information. Compared with non-HP patients, HP showed higher heart rate (72 ± 14 vs. 67 ± 14 beats per minute, P 7.32 mmHg (the fourth quartile for analyzed patients) was associated with a hazard ratio of 1.44 (95% Confidence intervals 1.00-2.07) for all-cause death, independently of LVOTG and LV EF. CONCLUSION: HP in HCM is associated with a disadvantageous systemic, cardiac and coronary hemodynamic profile as well as lower survival in the long-term.
Description
Citation
Publisher
License
Journal
European heart journal.Cardiovascular Imaging
Volume
26
Issue
10