The effect of hypertension on cardiac structure and function in different types of hypertrophic cardiomyopathy: A single-center retrospective study

Objectives: To determine whether hypertension (HTN) affects cardiac structure and function in different types of hypertrophic cardiomyopathy (HCM). Design: Patients with obstructive HCM (n = 40), septal HCM (n = 88), and apical HCM (n = 42) were separated into hypertensive and non-hypertensive subgroups, and echocardiographic parameters at baseline and at follow-up were compared between the subgroups. Results: At follow-up, hypertensive obstructive HCM patients showed a decrease in end-diastolic volume (from 93.87 +/- 26.08 mL to 79.06 +/- 20.07 mL; p= 0.045) and in left ventricular end-diastolic diameter (from 45.00 +/- 5.32 mm to 41.83 +/- 4.58 mm; p =0.042). Non-hypertensive obstructive HCM patients showed a decrease in maximum aortic velocity (from 2.01 +/- 0.53 m/s to 1.28 +/- 0.25 m/s; p= 0.011) and in aortic maximum pressure gradient (from 17.22 +/- 9.57 mm Hg to 6.79 +/- 2.44 mm Hg; p= 0.03). Hypertensive apical HCM patients showed an increase in end-diastolic volume (from 95.28 +/- 16.54 mL to 119.74 +/- 25.19 mL; p= 0.016) and in left ventricular end-diastolic diameter (from 45.28 +/- 3.36 mm to 50.20 +/- 4.56 mm; p= 0.007). Conclusions: HTN can affect left ventricular capacity in obstructive HCM and apical HCM, causing a decrease in ventricular capacity in the former and increase in the latter; it has no significant effect on the size of the left ventricular cavity in septal HCM. HTN can lead to a poor therapeutic effect on aortic flow rate and pressure gradient in obstructive HCM patients.