{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:36:55Z","timestamp":1783579015618,"version":"3.55.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Societ\u00e0 Italiana di Ecocardiografia e Cardiovascular Imaging"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Our aim was to assess the clinical and prognostic significance of the left ventricular (LV) hypercontractile phenotype (HP) in hypertrophic cardiomyopathy (HCM), which until now remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We enrolled 1533 HCM patients (age 51 \u00b1 15 years, 965 males, 63%) with ejection fraction (EF) \u2265 50%, referred for rest transthoracic echocardiography (TTE) in 27 laboratories from 13 countries. Two-dimensional volumetric TTE assessment included LV outflow tract gradient (LVOTG), LV EF, and LV force (systolic blood pressure + LVOTG\/ESV, mmHg\/mL). HP was defined as the highest quartile of the force (&amp;gt; 7.32\u2005mmHg\/mL). Survival analysis was performed in a subset of 1200 patients with follow-up information. Compared with non-HP patients, HP showed higher heart rate (72 \u00b1 14 vs. 67 \u00b1 14 beats per minute, P &amp;lt; 0.001), lower stroke volume (50 \u00b1 22 vs. 67 \u00b1 22\u2005mL, P &amp;lt; 0.001), larger left atrial volume index (44 \u00b1 16 vs. 40 \u00b1 16\u2005mL\/m2, P = 0.011) and higher coronary flow velocity in the mid-distal left anterior descending artery (n = 325, 41 \u00b1 12 vs. 37 \u00b1 14\u2005cm\/s, P = 0.021). Force was moderately related to LV EF (r = 0.48, P &amp;lt; 0.001) and weakly to LVOTG (r = 0.36, P &amp;lt; 0.001). During a median follow-up of 87 months (interquartile range 45\u2013143 months), 131 all-cause deaths occurred. At multivariable Cox analysis, a force &amp;gt; 7.32\u2005mmHg (the fourth quartile for analyzed patients) was associated with a hazard ratio of 1.44 (95% Confidence intervals 1.00\u20132.07) for all-cause death, independently of LVOTG and LV EF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>HP in HCM is associated with a disadvantageous systemic, cardiac and coronary hemodynamic profile as well as lower survival in the long-term.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaf238","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T11:28:51Z","timestamp":1756207731000},"page":"1675-1684","source":"Crossref","is-referenced-by-count":5,"title":["Hypercontractile phenotype in hypertrophic cardiomyopathy indicates unfavorable hemodynamics, coronary flow and prognosis"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7623-5389","authenticated-orcid":false,"given":"Karina","family":"Wierzbowska-Drabik","sequence":"first","affiliation":[{"name":"Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, ul. Kniaziewicza 1\/5, 91-347 Lodz ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eszter Dalma","family":"P\u00e1link\u00e1s","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Semmelweis University , Budapest ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"D\u2019Alfonso","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Mori","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Del Franco","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus Peteiro","family":"Vazquez","sequence":"additional","affiliation":[{"name":"CHUAC-Complexo Hospitalario Universitario A Coruna, CIBER-CV, University of A Coruna, 15070 La Coruna ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Re","sequence":"additional","affiliation":[{"name":"Division of Cardiology, San Camillo Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milorad","family":"Tesic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, Medical School, University of Belgrade , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Djordjevic-Dikic","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, Medical School, University of Belgrade , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"P\u00e1link\u00e1s","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Csongr\u00e1d-Csan\u00e1d County Health Care Centre and University Teaching Hospital, H\u00f3dmez\u0151v\u00e1s\u00e1rhely-Mak\u00f3, H\u00f3dmez\u0151v\u00e1s\u00e1rhely ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Aguiar","family":"Rosa","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universit\u00e1rio de Lisboa Central , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Angela","family":"Losi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Federico II University \u00a0 Naples 80131 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0336-5593","authenticated-orcid":false,"given":"Hugo","family":"Rodriguez-Zanella","sequence":"additional","affiliation":[{"name":"Department of Echocardiography and Noninvasive Hemodynamics, Ignacio Ch\u00e1vez National Institute of Cardiology, Juan Badiano No. 1 Tlalpan, 14080, Mexico City, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Cruz","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Garcia de Orta, Almada ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6408-4667","authenticated-orcid":false,"given":"Luis Rocha","family":"Lopes","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London, London WC1H 0QB ,","place":["UK"]},{"name":"Barts Heart Center, St Bartholomew\u2019s Hospital , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attila","family":"Nemes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Szent-Gy\u00f6rgyi Medical School, University of Szeged, Szeged ,","place":["Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelaide","family":"Arruda-Olson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Ultrasound and Non-Invasive Cardiology, Sichuan Provincial People's Hospital , Chengdu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixue","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Ultrasound and Non-Invasive Cardiology, Sichuan Provincial People's Hospital , Chengdu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni L","family":"Tripepi","sequence":"additional","affiliation":[{"name":"National Research Council - Institute of Clinical Physiology (CNR-IFC) of Reggio Calabria, Reggio Calabria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlena","family":"Broncel","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, ul. 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