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    Am Heart J. 2011 Nov;162(5):798-810.

    LV twisting and untwisting in HCM: ejection begets filling. Diastolic functional aspects of HCM.

    Pasipoularides A.

    Source

    School of Medicine, Duke University, Durham, NC 27710, USA. apasipou@duke.edu

    Abstract

    Conventional and emerging concepts on mechanisms by which hypertrophic cardiomyopathy (HCM) engenders diastolic dysfunction are surveyed. A shift from familiar left ventricular (LV) diastolic function approaches to large-scale (twist-untwist) and small-scale (titin unfolding-refolding, etc.) wall rebound models, incorporating interaction and dynamic distortions and rearrangements of myofiber sheets and ultrastructural constituents, is suggested. Such an emerging new paradigm of diastolic dynamics, emphasizing the relationship of myofiber sheet and ultraconstituent distortion to LV mechanics and end-systolic shape, might clarify intricate patterns of early diastolic rebound and suction, needed for LV filling in many of the polymorphic phenotypes of HCM.

    Copyright © 2011 Mosby, Inc. All rights reserved.

    PMID:
    22093194
    [PubMed - indexed for MEDLINE]

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