DIASTOLIC DYSFUNCTION IN HYPERTROPHIC NONOBSTRUCTIVE CARDIOMYOPATHY

Objective: The purpose of research was to assess the availability and prevalence of types of diastolic dysfunction of the left ventricle (LV) in hypertrophic nonobstructive cardiomyopathy (NHCM). Methods: 97 NHCM patients. Mean age 42,5±14,9 years. Diastolic dysfunction assessed by Doppler echocardiography. Results: Signs of chronic heart failure NYHA class I observed in 44 (45%) patients, class II — in 40 (41%), class III — in 13 (13%) patients. 83% patients had LV diastolic dysfunction, mainly on the hypertrophic type. One third of the patients had pseudonormal type with uncertain interpretation. Diastolic dysfunction in terms of clinical manifestations determined mainly NYHA class III and syncope. Severity of LV diastolic dysfunction in NHCM depended on the severity of hypertrophy not only left, but the right ventricle too. In 94% of cases we observed not only diastolic dysfunction, but also reduction of secondary fibers shortening fraction — as sign of contractile dysfunction. Conclusion: Thus, in NHCM dominated diastolic dysfunction of hypertrophic type. Such dysfunction defining a clinic cardiac deficiency or syncope. One third of the patients had pseudonormal transmitral flow type, difficult to assess diastolic function. Diastolic dysfunction in NHCM was combined with impaired contractility of the walls of ventricle.