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Pathophysiology and Therapeutic Needs in Nonobstructive Hypertrophic Cardiomyopathy

Milind Y Desai1, Niccolo Maurizi2, Elena Biagini3

  • 1HCM Center, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

JACC. Heart Failure
|September 25, 2025
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) is a heart condition affecting many globally. This review details nonobstructive HCM, its varied impacts, and current research for new treatments.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Hypertrophic cardiomyopathy (HCM) affects over 1 in 500 individuals globally.
  • Nonobstructive HCM, comprising 30-70% of cases, is highly heterogeneous.
  • It leads to significant morbidity, including heart failure and arrhythmias.

Purpose of the Study:

  • To provide a comprehensive overview of nonobstructive HCM.
  • To cover epidemiology, natural history, genetics, pathophysiology, and clinical aspects.
  • To discuss current treatments and ongoing clinical trials.

Main Methods:

  • This is a narrative review.
  • Literature search on nonobstructive HCM.
  • Synthesis of existing data on the condition.

Main Results:

  • Nonobstructive HCM presents with diverse clinical manifestations.
  • Genetic factors play a crucial role in its pathophysiology.
  • No pharmaceutical therapies are currently approved, but trials are active.

Conclusions:

  • Nonobstructive HCM requires further research due to its heterogeneity and burden.
  • Understanding its natural history and genetics is key.
  • Ongoing trials offer hope for future therapeutic strategies.

Keywords:
heart failurehypertrophic cardiomyopathynonobstructive

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