Which cardiomyopathy is primarily associated with diastolic dysfunction due to LV hypertrophy?

• A. Hypertrophic cardiomyopathy
• B. Dilated cardiomyopathy
• C. Restrictive cardiomyopathy
• D. Constrictive pericarditis

Answer: (A)

Hypertrophic cardiomyopathy is characterized by thickened left ventricular walls, often asymmetric, which makes the ventricle stiff and less able to relax during filling. This reduced compliance leads to impaired diastolic filling and higher filling pressures, so diastolic dysfunction is the main issue even if the systolic function can be preserved or only mildly affected.

Dilation of the ventricle with reduced pumping ability is the hallmark of dilated cardiomyopathy, which is a systolic problem. Restrictive cardiomyopathy does cause diastolic dysfunction, but it’s due to a stiff myocardium from infiltrative or fibrotic processes, not primarily because of LV hypertrophy. Constrictive pericarditis causes diastolic dysfunction due to external restriction from the pericardium, not because the heart muscle itself is hypertrophied.