{
  "abstract": "Hypertrophic cardiomyopathy (HCM) produces heterogeneous electrical phenotypes whose continuous organization, longitudinal evolution and clinical relevance remain poorly defined. We developed complementary variational-autoencoder representations to map HCM ECG morphology relative to physiological variation and characterize within-subject change. Using 5,194 normal-reference ECGs and 2,594 longitudinal visits from 650 individuals with HCM, we found that HCM overlapped the physiological manifold but extended towards its periphery, while an HCM-oriented manifold largely reorganized shared electrical modes. Mixed-effects models identified longitudinal drift in selected phenotypic axes. A lateral/frontal QRS-force coordinate remained time-dependent after censoring septal reduction therapy, atrial fibrillation and pacing, and lower values were associated with subsequent heart-failure risk in baseline and time-updated analyses. A time-conditioned change VAE identified four interpretable within-subject modes aligned with longer-term trajectories. Sarcomeric genotype was associated with phenotype position but not trajectory rate.",
  "abstract_shown": true,
  "affiliations": [
    "Universita di Pavia"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "P. Cerveri"
    },
    {
      "name": "M. H. Taconne"
    },
    {
      "name": "V. Corino"
    },
    {
      "name": "L. Mainardi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cweqk189mxvj2.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.02.26367092",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367092v1.full",
  "id": "cweqk189mxvj2",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367092v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367092v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cweqk189mxvj2.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T00:20:42Z",
      "native_id": "10.64898/2026.11.02.26367092",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367092v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Interpretable ECG manifolds link longitudinal electrical phenotypes to heart-failure risk in hypertrophic cardiomyopathy",
  "title_text": "Interpretable ECG manifolds link longitudinal electrical phenotypes to heart-failure risk in hypertrophic cardiomyopathy",
  "type": "preprint",
  "updated_at": "2026-11-05T12:20:15Z",
  "url": "https://research.draconitic.com/paper/cweqk189mxvj2",
  "venue": "medRxiv",
  "versions": []
}