Journal
AMERICAN HEART JOURNAL
Volume 162, Issue 5, Pages -Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ahj.2011.08.019
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Funding
- NHLBI NIH HHS [R01 HL050446] Funding Source: Medline
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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. (Am Heart J 2011;162:798-810.)
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