The following is the summary of “Echocardiographic Characteristics and Clinical Outcomes of the Hyperdynamic Heart: A ‘Super-Normal’ Heart is not a Normal Heart” published in the January 2023 issue of Cardiovascular Disease by Gotsman, et al.

Left ventricular (LV) ejection fractions (EFs) above the normal range characterize hyperdynamic hearts. Is that a good thing? Their study analyzed the effects of hyperdynamic heart conditions on diastolic properties. A hyperdynamic heart (EF >70%) was one of the subgroups used to assess a series of echocardiograms performed over 5 years. The examinations of patients with severe LV hypertrophy or valve disease were disqualified. In total, 16,994 people participated in the study. A hyperdynamic heart was found in 720 people (4.2%). 

Hyperdynamic heart patients tended to be older, female, and have comorbid conditions like high blood pressure, diabetes, and obesity. About 20% of the patients were diagnosed with heart failure. Their heart rates were higher, their ventricles were smaller, and their relative wall thickness was greater than any other group. There was a marked increase in the prevalence of diastolic dysfunction measured by any of the indices in the hyperdynamic group. There was an increase in LV mass, left atrial volume, relaxation (less mitral e′), deceleration time, LV end-diastolic pressures (high mitral E/e’ ratio), and peak tricuspid regurgitation gradient. Around 78% of the people had diastolic dysfunction, an abnormality in a structural or functional parameter. 

Hyperdynamic heart patients had a much lower chance of survival. The Cox regression analysis showed that subjects with a hyperdynamic systolic function had an increased prevalence of diastolic dysfunction and reduced survival over a median 9-year follow-up (hazard ratio 1.56, 95% confidence interval 1.38 to 1.76, P<0.001). To put it simply, a hyperdynamic heart is not a healthy heart.