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[The Structure of Concomitant Pathology in Patients With Hypertrophic Cardiomyopathy in The Older Age Group. Review
G A Shakaryants1, Yu N Belenkov1, V Yu Kaplunova1
1Sechenov First Moscow State Medical University, Moscow.
Insights
Hypertrophic cardiomyopathy (HCM) patients now live longer, but comorbidities like tumors and metabolic syndrome complicate diagnosis and treatment. This review examines HCM
Area of Science:
- Cardiology
- Oncology
- Genetics
Background:
- Modern treatments increase hypertrophic cardiomyopathy (HCM) patient survival.
- Concomitant pathologies significantly influence HCM prognosis.
- HCM comorbidities vary with age, from tumors in youth to metabolic syndrome and ischemic heart disease (IHD) in older adults.
Purpose of the Study:
- To analyze the wide range of HCM comorbidities.
- To investigate the impact of combined pathologies on HCM diagnosis and treatment.
- To review literature and present clinical observations on HCM with other organ system pathologies, including malignancies.
Main Methods:
- Literature review on HCM comorbidities.
- Analysis of long-term clinical observations of a large HCM patient cohort.
- Examination of HCM combined with malignant neoplasms and other systemic diseases.
Main Results:
- HCM prognosis is affected by genetic markers, neurohumoral systems, and hemodynamics.
- Older HCM patients face higher risks of metabolic syndrome, atherosclerosis, IHD, and hypertension.
- Malignant neoplasms represent a significant comorbidity requiring adjusted treatment strategies for both HCM and cancer.
Conclusions:
- Comorbidities significantly complicate HCM diagnosis and management.
- A comprehensive approach is necessary to address the interplay between HCM and other diseases, including cancer.
- Understanding these complex interactions is crucial for optimizing patient outcomes.
Abstract:
Advances in modern drug and surgical treatment of patients with hypertrophic cardiomyopathy (HCM) have resulted in a significant increase in the life expectancy of these extremely severe patients. Therefore, in addition to the genetic markers, major neurohumoral systems and morpho-functional parameters of intracardiac hemodynamics, the course and prognosis of the disease are influenced by concomitant pathology. In infancy and early childhood, HCM is associated with tumors of chromaffin tissue of various localizations; however, the older the patient, the greater the likelihood of developing metabolic syndrome, secondary atherosclerosis and ischemic heart disease (IHD), and hypertension, which significantly complicates the verification of the HCM diagnosis. We have previously described cases of IHD secondary to HCM, which significantly affected the course and prognosis of both diseases. However, in old age, other comorbidities may also occur in addition to the diseases described above. Based on long-term observation of a large cohort of patients, this article analyzes a wide range of HCM combinations with pathology of other organs and systems, including malignant neoplasms, which makes significant adjustments to the treatment of both the underlying disease and cancer. The material is presented in the form of a brief review of literature on this topic and our own clinical observations and studies.
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