{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:35:04Z","timestamp":1788586504309,"version":"build-2803163510"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/16\/75\/32383"],"award-info":[{"award-number":["PG\/16\/75\/32383"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023312","name":"Wellcome\/EPSRC Centre for Medical Engineering","doi-asserted-by":"crossref","award":["WT 203148\/Z\/16\/Z"],"award-info":[{"award-number":["WT 203148\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/501100023312","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Wellcome Trust Senior Research Fellowship","award":["209450\/Z\/17\/Z"],"award-info":[{"award-number":["209450\/Z\/17\/Z"]}]},{"name":"Oxford British Heart Foundation"},{"name":"Centre of Research Excellence","award":["RE\/18\/3\/34214"],"award-info":[{"award-number":["RE\/18\/3\/34214"]}]},{"name":"Oxford NIHR Biomedical Research Centre"},{"name":"Oxford British Heart Foundation Centre of Research Excellence"},{"DOI":"10.13039\/100000050","name":"National Heart Lung Blood Institute","doi-asserted-by":"publisher","award":["U01HL117006-01A1"],"award-info":[{"award-number":["U01HL117006-01A1"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Obstructive hypertrophic cardiomyopathy (oHCM) is characterized by dynamic obstruction of the left ventricular (LV) outflow tract (LVOT). Although this may be mediated by interplay between the hypertrophied septal wall, systolic anterior motion of the mitral valve, and papillary muscle abnormalities, the mechanistic role of LV shape is still not fully understood. This study sought to identify the LV end-diastolic morphology underpinning oHCM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Cardiovascular magnetic resonance images from 2398 HCM individuals were obtained as part of the NHLBI HCM Registry. Three-dimensional LV models were constructed and used, together with a principal component analysis, to build a statistical shape model capturing shape variations. A set of linear discriminant axes were built to define and quantify (Z-scores) the characteristic LV morphology associated with LVOT obstruction (LVOTO) under different physiological conditions and the relationship between LV phenotype and genotype. The LV remodelling pattern in oHCM consisted not only of basal septal hypertrophy but a combination with LV lengthening, apical dilatation, and LVOT inward remodelling. Salient differences were observed between obstructive cases at rest and stress. Genotype negative cases showed a tendency towards more obstructive phenotypes both at rest and stress.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LV anatomy underpinning oHCM consists of basal septal hypertrophy, apical dilatation, LV lengthening, and LVOT inward remodelling. Differences between oHCM cases at rest and stress, as well as the relationship between LV phenotype and genotype, suggest different mechanisms for LVOTO. Proposed Z-scores render an opportunity of redefining management strategies based on the relationship between LV anatomy and LVOTO.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac233","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T16:10:54Z","timestamp":1669651854000},"page":"807-818","source":"Crossref","is-referenced-by-count":30,"title":["Left ventricular anatomy in obstructive hypertrophic cardiomyopathy: beyond basal septal hypertrophy"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1671-3489","authenticated-orcid":false,"given":"Uxio","family":"Hermida","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London , 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU , 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair A","family":"Young","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London , 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Carapella","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London , 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry","family":"Carr-White","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Imaging, School of Biomedical Engineering and Imaging Sciences, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-8918","authenticated-orcid":false,"given":"Elena","family":"Lukaschuk","sequence":"additional","affiliation":[{"name":"NIHR Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, and Oxford University Hospitals NHS Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan K","family":"Piechnik","sequence":"additional","affiliation":[{"name":"NIHR Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, and Oxford University Hospitals NHS Foundation Trust , Oxford , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M","family":"Kramer","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Virginia Health System , Charlottesville, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind Y","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William S","family":"Weintraub","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute, Georgetown University , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9017-5645","authenticated-orcid":false,"given":"Stefan","family":"Neubauer","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford , Oxford , UK"},{"name":"NIHR Oxford Biomedical Research Centre, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of 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