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Published on: November 2, 2020
[Therapeutic approaches in hypertrophic cardiomyopathy: from symptom relief to precision therapy]
Alessia Argirò1, Mattia Zampieri2, Alberto Marchi2
1Unit Cardiomiopatie, AOU Careggi, Firenze.
Insights
Hypertrophic cardiomyopathy, a genetic heart condition, can lead to heart failure, often due to outflow tract obstruction. New myosin inhibitors show promise in improving symptoms and quality of life.
Area of Science:
- Cardiology
- Genetics
- Pharmacology
Background:
- Hypertrophic cardiomyopathy (HCM) is the most prevalent genetic cardiomyopathy.
- Key complications include arrhythmias and heart failure, potentially exacerbated by left ventricular outflow tract obstruction (LVOTO).
Approach:
- This narrative review summarizes current and emerging therapeutic strategies for HCM.
- Treatments for LVOTO encompass pharmacological agents and septal reduction therapies.
Key Points:
- Pharmacological options include beta-blockers, calcium channel blockers, and disopyramide.
- Septal reduction therapies involve alcohol septal ablation and surgical myectomy.
- Myosin inhibitors are a novel therapeutic class demonstrating efficacy in clinical trials.
Conclusions:
- Myosin inhibitors offer a new treatment avenue for obstructive HCM, improving symptoms, function, and quality of life.
- The review covers existing and investigational treatments for hypertrophic cardiomyopathy.
Abstract:
Hypertrophic cardiomyopathy is the most common genetic cardiomyopathy. Main complications include the development of arrhythmias and heart failure, and the latter may be triggered by left ventricular outflow tract obstruction. The treatment of left ventricular outflow tract obstruction includes pharmacological therapies (beta-blockers, calcium channel blockers, disopyramide) and septal reduction therapies (alcohol septal ablation, surgical myectomy). Myosin inhibitors represent a new therapeutic opportunity and in recent clinical trials proved effective in symptom relief, improvement of functional capacity and quality of life in patients with obstructive hypertrophic cardiomyopathy. In this narrative review we will summarize the available and under development therapeutic approaches for hypertrophic cardiomyopathy.
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