Familial Hypertrophic Cardiomyopathy: Diagnosis and Management

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.

Keywords:

• hypertrophic cardiomyopathy
• genetics
• heart failure
• myosin
• mavacamten

Disclosure

N.R. reports support from the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2TR001879 and honoraria from Zoll. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The remaining authors report no conflicts of interest in this work.