ArticleEuropean heart journal. Cardiovascular Imaging2023
Novel insights into diminished cardiac reserve in non-obstructive hypertrophic cardiomyopathy from four-dimensional flow cardiac magnetic resonance component analysis.
Article in European heart journal. Cardiovascular Imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 8 citations in OpenAlex.
- Immature and mature myocardium in the pathophysiology of hypertrophic cardiomyopathy.Journal of molecular and cellular cardiology plus · 2026Review
- Cardiac morphology and flow dynamics in children born to hypertensive pregnancies.European heart journal. Imaging methods and practice · 2026Article
- Left ventricular flow components and myocardial deformation following treatment for hypertrophic obstructive cardiomyopathy: a retrospective cardiac magnetic resonance-based cohort of mavacamtenCardiovascular diagnosis and therapy · 2026Article
- Prognostic Value of Left Ventricular Kinetic Energy for Predicting Major Adverse Events in Hypertrophic Cardiomyopathy.JACC. Asia · 2026Article
- Unlocking the Hemodynamic Signature in Hypertrophic Cardiomyopathy: A Path to Better Risk Stratification.JACC. Asia · 2026Article
- Hemodynamic Patterns in Septic Cardiomyopathy: Insights From Echocardiographic Parameters and Biomarker Analysis.Cureus · 2025Article
- Cardiovascular magnetic resonance left ventricular 4D-flow: differences in flow components and kinetic energy across heart failure spectrum.European heart journal. Imaging methods and practice · 2025Article
- Cardiac Functional Assessment by Magnetic Resonance Imaging.Cardiology discovery · 2024Review
- Flow inefficiencies in non-obstructive HCM revealed by kinetic energy and hemodynamic forces on 4D-flow CMR.European heart journal. Imaging methods and practice · 2024Article
- Hypertrophic Cardiomyopathy: Genetic Foundations, Outcomes, Interconnections, and Their Modifiers.Medicina (Kaunas, Lithuania) · 2023Review
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
aimsHypertrophic cardiomyopathy (HCM) is characterized by hypercontractility and diastolic dysfunction, which alter blood flow haemodynamics and are linked with increased risk of adverse clinical events. Four-dimensional flow cardiac magnetic resonance (4D-flow CMR) enables comprehensive characterization of ventricular blood flow patterns. We characterized flow component changes in non-obstructive HCM and assessed their relationship with phenotypic severity and sudden cardiac death (SCD) risk. METHODS AND
resultsFifty-one participants (37 non-obstructive HCM and 14 matched controls) underwent 4D-flow CMR. Left-ventricular (LV) end-diastolic volume was separated into four components: direct flow (blood transiting the ventricle within one cycle), retained inflow (blood entering the ventricle and retained for one cycle), delayed ejection flow (retained ventricular blood ejected during systole), and residual volume (ventricular blood retained for >two cycles). Flow component distribution and component end-diastolic kinetic energy/mL were estimated. HCM patients demonstrated greater direct flow proportions compared with controls (47.9 ± 9% vs. 39.4 ± 6%, P = 0.002), with reduction in other components. Direct flow proportions correlated with LV mass index (r = 0.40, P = 0.004), end-diastolic volume index (r = -0.40, P = 0.017), and SCD risk (r = 0.34, P = 0.039). In contrast to controls, in HCM, stroke volume decreased with increasing direct flow proportions, indicating diminished volumetric reserve. There was no difference in component end-diastolic kinetic energy/mL.
conclusionNon-obstructive HCM possesses a distinctive flow component distribution pattern characterised by greater direct flow proportions, and direct flow-stroke volume uncoupling indicative of diminished cardiac reserve. The correlation of direct flow proportion with phenotypic severity and SCD risk highlight its potential as a novel and sensitive haemodynamic measure of cardiovascular risk in HCM.
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