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EACVI survey on hypertrophic cardiomyopathy
Tomaz Podlesnikar1,2, Nuno Cardim3,4, Nina Ajmone Marsan5
1Department of Cardiac Surgery, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
European Heart Journal. Cardiovascular Imaging
|December 27, 2021
Summary
Global survey reveals most centers follow European guidelines for hypertrophic cardiomyopathy (HCM) diagnosis and management. Emphasis on provocation maneuvers and exercise stress echocardiography for LV outflow obstruction is needed, with additional sudden cardiac death (SCD) risk markers potentially updating recommendations.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Clinical Practice
Background:
- Hypertrophic cardiomyopathy (HCM) management requires standardized assessment and follow-up.
- Global practices for HCM patient care vary, necessitating evaluation of current approaches.
Purpose of the Study:
- To assess current global practices for the diagnosis and management of hypertrophic cardiomyopathy (HCM).
- To evaluate the utilization of imaging modalities and risk stratification tools in HCM care.
Main Methods:
- A global survey was conducted by the EACVI Scientific Initiatives Committee.
- Responses from 213 centers across 38 countries detailed patient management, imaging techniques (echocardiography, CMR), and risk assessment for sudden cardiac death (SCD).
Main Results:
- Most centers (57%) manage HCM patients in general cardiology clinics, while 40% use specialized clinics.
- Echocardiography is primary, with CMR as a complementary tool. Bedside provocation maneuvers (49%) and exercise stress echocardiography (55%) are used for LV obstruction assessment.
- The HCM Risk-SCD score is widely used, but additional markers like late gadolinium enhancement and LV apical aneurysm are also employed for ICD decisions. Regular imaging follow-up (99%) is standard.
Conclusions:
- The majority of centers adhere to European guidelines for HCM diagnosis and management.
- Enhanced emphasis on provocation maneuvers and exercise stress echocardiography is recommended for diagnosing LV outflow obstruction.
- The use of additional SCD risk markers suggests a potential need to update current European recommendations.
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