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Diastolic Relaxation of the Heart pp 291–304Cite as

Failure of Inactivation of Hypertrophied Myocardium: A Cause of Impaired Left Ventricular Filling in Hypertrophic Cardiomyopathy and Aortic Stenosis

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Abstract

Impaired left ventricular filling has been observed in hypertrophic cardiomyopathy [1–5] and in pressure overload hypertrophy [1, 4, 6–12]. This impairment of left ventricular filling has been related to slow left ventricular pressure decay [13, 14], which prolongs isovolumic relaxation and impedes left ventricular inflow [15, 16]. A slow left ventricular pressure decay, persisting into the left ventricular filling phase can be explained by a failure of myocardial inactivation [17, 18], which causes incomplete myoplasmic calcium reuptake and favors persistent diastolic cross-bridge interaction and contractile tension generation. A failure of myocardial inactivation of the hypertrophied left ventricle could be induced by a shift of certain critical proteins involved in excitation-contraction coupling towards isomeric forms with slower enzyme kinetics and an altered calcium sensitivity [19, 20].

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Authors
  1. Walter J. Paulus
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  2. Stanislas U. Sys
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  3. Paul Nellens
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  4. Guy R. Heyndrickx
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  5. Eric Andries
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Editor information

Editors and Affiliations

  1. Harvard Medical School, Cardiovascular Division, Beth Israel Hospital, Boston, Massachusetts, USA

    William Grossman M.D. (Herman Dana Professor of Medicine, Chief) (Herman Dana Professor of Medicine, Chief)

  2. Harvard Medical School, Hemodynamic Research Laboratory, Beth Israel Hospital, Boston, Massachusetts, USA

    Beverly H. Lorell M.D. (Assistant Professor of Medicine, Co-Director) (Assistant Professor of Medicine, Co-Director)

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© 1987 Martinus Nijhoff Publishing

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Paulus, W.J., Sys, S.U., Nellens, P., Heyndrickx, G.R., Andries, E. (1987). Failure of Inactivation of Hypertrophied Myocardium: A Cause of Impaired Left Ventricular Filling in Hypertrophic Cardiomyopathy and Aortic Stenosis. In: Grossman, W., Lorell, B.H. (eds) Diastolic Relaxation of the Heart. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6832-2_27

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  • DOI: https://doi.org/10.1007/978-1-4615-6832-2_27

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4615-6834-6

  • Online ISBN: 978-1-4615-6832-2

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