Phenotyping the Many Faces of Hypertrophic Cardiomyopathy

Paul Geenty1, Belinda Gray2, Liza Thomas3

  • 1Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales 2050, Australia; Department of Cardiology, Westmead Hospital, Westmead, New South Wales 2145, Australia.

Heart Failure Clinics
|October 13, 2025
PubMed

Insights

Hypertrophic cardiomyopathy, an inherited heart condition, presents diverse symptoms. Accurate phenotyping helps identify patient groups for tailored prognosis and sudden cardiac death prevention.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiomyopathy.
  • It is defined by left ventricular hypertrophy (LVH) ≥15 mm without other causes.
  • HCM exhibits a heterogeneous clinical phenotype.

Purpose of the Study:

  • To emphasize the importance of accurate clinical phenotyping in hypertrophic cardiomyopathy.
  • To highlight the varied clinical manifestations and their impact on prognosis.
  • To underscore the necessity of risk stratification for preventing sudden cardiac death.

Main Methods:

  • Clinical data review.
  • Phenotypic classification of hypertrophic cardiomyopathy patients.
  • Prognostic factor analysis.

Main Results:

  • Identified key clinical manifestations including left ventricular outflow tract obstruction, mitral valve abnormalities, and ventricular arrhythmias.
  • Demonstrated that distinct phenotypic groups have different natural histories.
  • Highlighted the link between specific phenotypes and risk for sudden cardiac death.

Conclusions:

  • Accurate clinical phenotyping is essential for understanding hypertrophic cardiomyopathy.
  • Phenotypic characterization enables better risk stratification and personalized management.
  • Targeted interventions based on phenotype can improve patient outcomes and prevent sudden cardiac death.

Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
401
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
338
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
502
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
468
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
453
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.9K