Comprehensive evaluation of hypertrophic cardiomyopathy: European Journal of Heart Failure expert consensus document - PubMed
14 hours ago
- #Hypertrophic cardiomyopathy
- #Cardiac disease
- #Multidisciplinary care
- Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease and a leading cause of heart failure and sudden cardiac death (SCD) in young adults.
- A structured and multidisciplinary approach to care is essential due to HCM's complex pathophysiology, phenotypic diversity, and rapidly evolving therapeutic landscape.
- The manuscript proposes a six-pillar framework to standardize and optimize HCM evaluation and management.
- Pillar 1: Establishing the correct diagnosis using multimodal imaging and genetic testing to differentiate sarcomeric HCM from phenocopies like amyloidosis, Fabry, or mitochondrial disease.
- Pillar 2: Evaluating symptoms and left ventricular outflow tract obstruction (LVOTO) through dynamic assessment with exercise echocardiography to guide treatment.
- Pillar 3: Risk stratification for SCD integrates risk scores and imaging data to inform implantable cardioverter defibrillator decisions.
- Pillar 4: Genetic evaluation and family management enable cascade testing, early detection, and counseling.
- Pillar 5: Managing comorbidities such as atrial fibrillation, hypertension, obesity, and sleep-disordered breathing for holistic care and symptom control.
- Pillar 6: Education and lifestyle guidance focus on safe sport participation, avoiding dehydration and vasodilators, and reproductive counseling in a multidisciplinary setting.