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Systolic and diastolic left ventricular and myocardial performance were analysed in ten patients with hypertrophic obstructive cardiomyopathy (HOCM) from biplane cineangiograms and simultaneous pressure recordings. In spite of significant geometrical abnormalities, pump function of the left ventricle on the average was normal. Only in two cases ejection fraction and isovolumic phase indices, respectively, were moderately reduced. On the contrary nine of ten patients had a considerable reduction of left ventricular distensibility, partly due to a decreased myocardial compliance. The symptoms of patients with HOCM cannot be explained by an impaired systolic pump function, they are primarily caused by a disturbed ventricular und myocardial function during diastole.
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