Tehran University of Medical Sciences

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Hypertrophic Cardiomyopathy With Left Ventricular Systolic Dysfunction: Integrating Pharmacological, Device, and Advanced Heart Failure Therapies Publisher Pubmed



Tajdini M ; Tavakoli K ; Jenkin SC ; Keykhaei M ; Hahn VS
Authors

Source: Journal of Cardiac Failure Published:2026


Abstract

Hypertrophic cardiomyopathy with left ventricular systolic dysfunction (HCM-LVSD) is a severe manifestation of HCM that is defined by a left ventricular ejection fraction <50%. LVSD is a risk factor for sudden cardiac death that warrants consideration of an implantable cardioverter-defibrillator. Pharmacological therapies are limited to guideline-directed medical therapy for heart failure with reduced ejection fraction, regardless of etiology. Patients with HCM-LVSD suffer from high morbidity and mortality rates, often requiring advanced heart failure therapies. Heart transplantation remains the definitive treatment for end-stage disease, but left ventricular assist devices (LVADs) can serve as bridges to transplantation in selected cases, despite unique anatomical challenges and higher complication rates. Future research must address the knowledge gaps in the prevention and treatment of HCM-LVSD, aiming to enhance quality of life, prevent the need for advanced heart failure therapies, and prolong survival. © 2026 The Authors.