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Major Clinical Issues in Hypertrophic Cardiomyopathy
Hyun-Jung Lee1, Jihoon Kim2, Sung-A Chang2
1Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Korean Circulation Journal
|August 5, 2022
Summary
Hypertrophic cardiomyopathy (HCM) management has improved, but risks like sudden cardiac death (SCD) and heart failure persist. Advanced imaging aids risk evaluation for better patient outcomes in HCM.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) is a common inherited heart muscle disease.
- Despite advances in treatment, HCM poses significant health challenges, particularly in Korea.
- Key concerns include sudden cardiac death (SCD), atrial fibrillation, thromboembolism, outflow tract obstruction, and heart failure progression.
Purpose of the Study:
- To review contemporary management strategies for hypertrophic cardiomyopathy.
- To highlight persistent challenges and evolving treatment approaches for HCM patients.
- To emphasize the role of risk stratification and advanced imaging in HCM care.
Main Methods:
- Review of current clinical guidelines and therapeutic options for HCM.
- Discussion of risk factors and preventative strategies for SCD.
- Overview of pharmacological and interventional treatments for LVOT obstruction and heart failure.
- Integration of advanced imaging techniques for risk assessment.
Main Results:
- Implantable cardioverter-defibrillators are effective for SCD prevention in selected HCM patients.
- Anticoagulation is recommended for all HCM patients with atrial fibrillation.
- Medical management and septal reduction therapy address LVOT obstruction, with mavacamten showing promise.
- Myocardial fibrosis and diastolic dysfunction are key in HF progression, with heart transplantation as an option for refractory cases.
Conclusions:
- Current management strategies have improved HCM outcomes, but significant risks remain.
- Appropriate patient selection for interventions like ICDs and tailored medical therapies are crucial.
- Advanced imaging techniques enhance risk stratification and guide personalized management decisions in HCM.
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