Left Ventricular Remodeling in Hypertrophic Cardiomyopathy: An Overview of Current Knowledge

While most patients with hypertrophic cardiomyopathy (HCM) show a relatively stable morphologic and clinical phenotype, in some others, progressive changes in the left ventricular (LV) wall thickness, cavity size, and function, defined, overall, as LV remodeling, may occur. The interplay of multiple pathophysiologic mechanisms, from genetic background to myocardial ischemia and fibrosis, is implicated in this process. Different patterns of LV remodeling have been recognized and are associated with a specific impact on the clinical course and management of the disease. These findings underline the need for and the importance of serial multimodal clinical and instrumental evaluations to identify and further characterize the LV remodeling phenomenon. A more complete definition of the stages of the disease may present a chance to improve the management of HCM patients.

Automated summary

While most patients with hypertrophic cardiomyopathy (HCM) exhibit a stable phenotype, certain patients may experience progressive changes in left ventricular (LV) wall thickness, cavity size, and function, overall defined as LV remodeling. Various pathophysiologic mechanisms, from genetic factors to myocardial ischemia and fibrosis, contribute to this process. Different patterns of LV remodeling have specific impacts on the clinical course and management of the disease, underscoring the importance of serial multimodal evaluations to identify and characterize LV remodeling. A more comprehensive definition of disease stages may offer opportunities to improve management of HCM patients.