Hypertrophic Cardiomyopathy — Beyond the Sarcomere

Remodeling of the left ventricle by the process of hypertrophy is usually a response to increased afterload. This adaptive reaction maintains cardiac output. The most common pattern of hypertrophy is concentric remodeling due to systemic hypertension, in which there is replication of sarcomeres in parallel. Hypertrophy also results from genetic mutations involving the contractile apparatus, as in hypertrophic cardiomyopathy, which is unrelated to changes in afterload.Echocardiography has made it possible to quantify hypertrophy and to describe the effects of hypertrophic cardiomyopathy on left ventricular architecture and function. These patterns have proved invaluable in identifying phenotypic expression in family pedigrees. . . .