Reflections of Inflections in Hypertrophic Cardiomyopathy

Mark V. Sherrid, Omar Wever-Pinzon, Ajay Shah, Farooq A. Chaudhry

Research output: Contribution to journalReview articlepeer-review

53 Scopus citations


The shape of Doppler velocity tracings in obstructive hypertrophic cardiomyopathy offers insights into its pathophysiology. Inflection points are the points on a curve where its shape changes from concave to convex, or vice versa. These dynamic systolic abnormalities are caused: 1) by the amplifying nature of the obstruction; and 2) by the adverse effect of the sudden imposition of afterload in midsystole. The midsystolic drop in left ventricular ejection velocities and the premature termination of longitudinal shortening are compelling evidence of the deleterious mechanical effect of obstruction on the ventricle. This dynamic systolic dysfunction, demonstrated on the Doppler curves, may contribute to heart failure symptoms and adverse outcome. In outflow obstruction, these abnormalities normalize after abolition of gradient. Therefore, their detection in an individual patient confirms obstruction as a therapeutic target.

Original languageEnglish
Pages (from-to)212-219
Number of pages8
JournalJournal of the American College of Cardiology
Issue number3
StatePublished - 14 Jul 2009
Externally publishedYes


  • Doppler echocardiography
  • echocardiography
  • heart failure
  • hypertrophic cardiomyopathy
  • left ventricular outflow obstruction


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