Rowin EJ, Maron BJ, Wells S, et al. - Researchers herein assessed systolic function markers, including the role of global longitudinal strain (GLS), to detect nonobstructive hypertrophic cardiomyopathy (HC) cases at risk for future heart failure. Participants were 296 consecutive nonobstructive HC patients (42 ± 18years; 75% male) having NYHA class I/II symptoms and preserved systolic function at study entry (EF: 65 ± 6%). They were observed for progressive heart failure symptoms (elevation in ≥ 1 NYHA functional class) and/or development of systolic dysfunction (EF < 50%). Findings revealed that abnormal GLS, in nonobstructive HC patients with no or mild symptoms and preserved EF, was identified as a strong independent predictor for subsequent development of progressive heart failure symptoms and/or systolic dysfunction. In nonobstructive HC, the greatest power in predicting results was obtained by integrating GLS with EF to recognize HC cases at the highest risk for heart failure progression and systolic dysfunction.