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

  • Walter J. Paulus
  • Stanislas U. Sys
  • Paul Nellens
  • Guy R. Heyndrickx
  • Eric Andries


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].


Aortic Stenosis Left Ventricular Filling Left Ventricular Relaxation Ventricular Relaxation Hypertrophied Left Ventricle 
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© Martinus Nijhoff Publishing 1987

Authors and Affiliations

  • Walter J. Paulus
  • Stanislas U. Sys
  • Paul Nellens
  • Guy R. Heyndrickx
  • Eric Andries

There are no affiliations available

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