For a study, researchers sought to explore morphological dynamics and their link with patient features and clinical outcomes in a large cohort of nonapical hypertrophic cardiomyopathy (HC) patients who had undergone 2 serial cardiac magnetic resonance scans. The study involved 214 patients with nonapical HC who underwent 2 sequential cardiac magnetic resonance examinations separated by a mean of somewhere between 4.8 ± 2.1 years. The progression of the left ventricular mass index (LVMI) was associated with lower LVMI at baseline (P<0.00001) and age of more than 50. Progression was related to a lower maximum wall thickness (MWT) at baseline and with the presence of LV outflow tract blockage. There was no correlation between the evolution of LVMI or MWT and baseline LV volumes, mitral regurgitation severity, gender, or the presence of pathogenic HC variations. Significant associations were found between left atrial enlargement and the onset of atrial fibrillation (P=0.014; odds ratio 1.18, CI 1.03 to 1.35) and admission for heart failure (P=0.018; odds ratio 1.18, CI 1.03 to 1.36) There was no association between changes in LV mass or MWT and hospitalization for heart failure, progression to New York Heart Association 2/3, progression to end-stage HC, or implantation of an implanted cardioverter-defibrillator. In conclusion, the research gave unique morphological insights into the natural history of HC. It demonstrated that HC was a dynamic disease in which the shape and amount of hypertrophy of the left ventricle (LV) alter over time, and risk factors were linked with disease development.