Pseudonormalization of global myocardial work index and global constructive work, but not global wasted work, in patients with obstructive hypertrophic cardiomyopathy

Abstract Background/objectives Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by left ventricular hypertrophy, often leading to diastolic dysfunction and, in some cases, dynamic outflow tract obstruction. In recent years, myocardial work (MW) parameters, derived from novel echocardiographic techniques, have emerged as sophisticated indices for the quantitative assessment of systolic myocardial contractile function. The present study sought to elucidate the intricate interrelationships among these MW parameters and to delineate their differential characteristics in patients presenting with non-obstructive versus obstructive HCM. Methods The present study enrolled 118 patients with HCM [77 men (65%), mean age: 53±13 years], including 68 non- obstructive (nHCM) and 50 obstructive (oHCM) patients. In all cases a comprehensive echocardiography has been performed, inculding global longitudinal strain (GLS) and derived MW parameters (global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). The patients were further classified into subgroups according to of the left ventricular outflow tract (LVOT) gradient: 50 Hgmm and >70 Hgmm. Results GLS values decreased gradually (from -15.1 to -14.2%) as LVOT gradients increased. This difference compared to controls was significant even in the HCM group with LVOT gradients