<prompt> All are true about hyperophic cardiomyopathy exceptSystolic dysfunctionConcenteric hyperophyDiastolic dysfunctionDouble apical impulse  <response>: Ref Harrison 19 th ed pg 1568 Biopsy is not needed to diagnose hyperophic cardiomyopathy but can be used to exclude infiltrative and metabolic diseases. Rigorous athletic training athletes hea may cause intermediate degrees of physiologic hyperophy difficult to differentiate from mild hyperophic cardiomyopathy. Unlike hyper- trophic cardiomyopathy, hyperophy in the athletes hea regresses with cessation of training, and is accompanied by supernormal exer- cise capacity VO2max 50 mLkgmin, mild ventricular dilation, and normal diastolic function. 