Clinical benefits of a specialised clinic for hypertrophic cardiomyopathy
A Beale1, I Macciocca, A Olaussen
1HCM Clinic @ The Alfred, Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia.
Insights
Attendance at a specialized hypertrophic cardiomyopathy (HCM) clinic improves patient management, including investigations, medication, and family screening. This demonstrates the value of dedicated HCM centers for comprehensive care.
Area of Science:
- Cardiology
- Genetics
- Clinical Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) is a prevalent monogenic cardiac disease.
- Management strategies for HCM are evolving, with a growing emphasis on specialized care centers.
Purpose of the Study:
- To evaluate the clinical impact of attending a specialized HCM clinic on patient management.
- To assess improvements in diagnostic investigations, therapeutic interventions, and family screening.
Main Methods:
- Retrospective analysis of patients attending a dedicated HCM clinic over two years.
- Outcome measures included changes in diagnostic testing, medication optimization, device referrals, and family screening.
Main Results:
- Increased utilization of 24-h Holter monitoring (39%), stress echocardiography (21%), and cardiac MRI (70%).
- Medication optimization in 47% of patients; 6% received implantable cardioverter-defibrillators (ICDs) and 13% underwent septal myectomy.
- Screening of 70 first-degree relatives (FDR) identified 10 new HCM cases.
Conclusions:
- Specialized HCM clinics facilitate cardiac investigations and optimize medical therapy.
- These centers streamline referrals for ICDs and septal reduction therapy, enhancing family screening.
- Comprehensive management at specialized clinics is recommended for all HCM patients.
Background:
Hypertrophic cardiomyopathy (HCM) is the most common monogenic cardiac condition, with a range of investigation and management options available. Recent research has recommended management within multidisciplinary-dedicated HCM centres.
Aim:
To assess the clinical impact of attendance at a specialised clinic on the management of HCM.
Methods:
A retrospective study of patients attending the HCM Clinic @ The Alfred during the first 2 years of operation was performed. Outcome measures comprised improvements in management of HCM as a result of attending the clinic including risk stratification and further investigations, medication changes, referral for implantable cardioverter-defibrillators (ICD) and septal reduction therapy, and screening of first-degree relatives (FDR).
Results:
Following specialised clinic attendance, there was an increase in patients investigated with 24-h Holter monitoring by 39%, stress echocardiography by 21% and cardiac magnetic resonance imaging by 70%. Medications were optimised in 47% of patients. Six per cent of patients underwent ICD implantation and 13% underwent septal myectomy. Seventy new FDR were screened identifying 10 new cases of HCM.
Conclusions:
Attendance at our specialised HCM clinic leads to facilitation of cardiac investigations, optimisation of medical therapy, streamlining of referrals for ICD implantation and septal reduction therapy, and improved family screening. Referral to a specialised clinic offering comprehensive management should be considered for all patients with HCM.
More Related Videos
Related Concept Videos
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
01:22Heart Failure VI: Adjunct Therapies
01:25Cardiomyopathy I: Introduction and Classification