Frequency of Left Ventricular Dysfunction in Hypertrophic and Ischemic Cardiomyopathy Patients

Abstract

Background:  Cardiomyopathies are a significant cause of heart failure, arrhythmias, and cardiovascular mortality worldwide. Among them, hypertrophic cardiomyopathy (HCM) and ischemic cardiomyopathy (ICM) are the most prevalent, with distinct pathophysiological effects on left ventricular (LV) function. While LV dysfunction is a key determinant of prognosis, data on its frequency and demographic distribution in South Asian populations, particularly Pakistan, remain limited. Objective:  This study aimed to determine the frequency of LV dysfunction in patients with HCM and ICM and to assess its distribution according to age and gender using echocardiography. Methods:  A descriptive cross-sectional study was conducted at Rehman Medical Institute, Peshawar, Pakistan, from July to December 2025. A total of 378 patients aged 30–70 years diagnosed with HCM, ICM, or both were included using convenience sampling. LV dysfunction was evaluated by transthoracic echocardiography, assessing systolic and diastolic function according to American Society of Echocardiography guidelines. Descriptive statistics were used to summarize frequencies and percentages of LV dysfunction across cardiomyopathy types, age groups, and gender. Results:  Among 378 patients (54.5% males; mean age 54.4 ± 9.5 years), 159 (42%) had HCM, 183 (48.4%) had ICM, and 36 (9.5%) had both. Overall, LV dysfunction was observed in 77.8% of participants. In HCM patients, LV dysfunction was present in 64.5%, predominantly diastolic (39.4%), with 25.1% showing systolic impairment. ICM patients had a higher prevalence of LV dysfunction (87.7%), mainly systolic (64.8%), with 22.8% diastolic dysfunction. Patients with both HCM and ICM exhibited LV dysfunction in 87.2%. LV dysfunction increased with age, especially in patients aged 51–70 years, and was more frequent in males across both cardiomyopathy groups. Conclusion:  LV dysfunction is highly prevalent in patients with cardiomyopathy in Pakistan, particularly in ICM, with distinct patterns by disease type, age, and gender. These findings highlight the importance of routine echocardiographic assessment for early detection and management of high-risk patients, and provide valuable regional data to guide clinical practice.

Keywords:  Left ventricular dysfunction, Hypertrophic cardiomyopathy, Ischemic cardiomyopathy, Echocardiography, cardiomyopathy