• Echocardiography is the first-line technique to assess systolic and diastolic function in HCM.
• The assessment of systolic function should include conventional data (EF, SF, SVI) and recent parameters (longitudinal LV function with DMI and 2D-STE). The 2D-speckle tracking assessment of LV systolic radial and circumferential function as well as rotational and twist mechanics are currently not recommended as clinical tools, but can be used for research.
• Diastolic parameters should include lateral E/e’, Ar-A, LAVI and sPAP. Isolated transmitral inflow patterns and grades should not be used to quantify LV filling pressures. The 2D-STE assessment of diastolic function (LV and LA) is still a research tool.
• CMR with LGE assessment is recommended in HCM since the presence and extent of fibrosis has been related to progressive LV dilatation and systolic dysfunction.
• Nuclear imaging methods and cardiac CT have limited indications in the assessment of systolic and diastolic function in this disease.