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Published on: August 8, 2022
Familial Hypertrophic Cardiomyopathy: Diagnosis and Management
Michael J Litt1, Ayan Ali2, Nosheen Reza1
1Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Insights
Hypertrophic cardiomyopathy (HCM), a common inherited heart condition, is better understood through advances in imaging and genetics. Modern multidisciplinary care and therapies improve patient outcomes.
Area of Science:
- Cardiology
- Genetics
- Molecular Biology
Background:
- Hypertrophic cardiomyopathy (HCM) is a prevalent inherited cardiac disorder.
- Over 60 years of research have advanced understanding through imaging and genetics.
- Multimodality imaging and translational genetics have revolutionized HCM knowledge.
Purpose of the Study:
- To review the molecular pathophysiology of HCM.
- To describe clinical presentations and the role of genetic testing.
- To summarize management strategies for HCM subtypes.
Main Methods:
- Review of current literature on HCM pathophysiology, genetics, and clinical management.
- Discussion of diagnostic approaches including genetic testing.
- Analysis of therapeutic strategies for hemodynamic subtypes.
Main Results:
- Modern understanding of HCM molecular pathophysiology.
- Comprehensive overview of clinical presentations and diagnostic roles of genetic testing.
- Summary of evidence for therapies like ICDs, septal reduction, and myosin inhibitors.
Conclusions:
- Diagnosis and management are optimized with a multidisciplinary approach.
- Personalized care and improved outcomes are achievable with current therapies.
- Advances in understanding and treatment continue to enhance patient care for HCM.
Abstract:
Hypertrophic cardiomyopathy (HCM) is widely recognized as one of the most common inheritable cardiac disorders. Since its initial description over 60 years ago, advances in multimodality imaging and translational genetics have revolutionized our understanding of the disorder. The diagnosis and management of patients with HCM are optimized with a multidisciplinary approach. This, along with increased safety and efficacy of medical, percutaneous, and surgical therapies for HCM, has afforded more personalized care and improved outcomes for this patient population. In this review, we will discuss our modern understanding of the molecular pathophysiology that underlies HCM. We will describe the range of clinical presentations and discuss the role of genetic testing in diagnosis. Finally, we will summarize management strategies for the hemodynamic subtypes of HCM with specific emphasis on the rationale and evidence for the use of implantable cardioverter defibrillators, septal reduction therapy, and cardiac myosin inhibitors.
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