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Published in: Heart Failure Reviews 5/2021

01-09-2021 | Sudden Cardiac Death

Phenotypes of hypertrophic cardiomyopathy: genetics, clinics, and modular imaging

Authors: Ioana Danuta Muresan, Lucia Agoston-Coldea

Published in: Heart Failure Reviews | Issue 5/2021

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Abstract

Hypertrophic cardiomyopathy (HCM) is the most common cardiovascular disease with genetic transmission, characterized by the hypertrophy of any segment of the left ventricle (LV), not totally explained by improper loading conditions, with LV systolic function preserved, increased, or reduced. The histopathological mechanism involved in HCM refers to the primary injury of the myocardium, as follows: disorganized array of myocytes, extracellular matrix modification, microvascular dysfunction, with subsequent appearance of myocardial fibrosis. Multiple sarcomere proteins mutations are responsible for HCM, but two of them are involved in 70% of the cases of HCM: β-myosin heavy chain (MYH7) and myosin-binding protein C (MYBPC3). The development of new genetic techniques involving genome editing is promising to discover a gene therapy for patients with HCM. Clinical presentation may differ from asymptomatic to sudden cardiac death (SCD), the last one targeting younger adults. In this case, the diagnosis and evaluation of SCD risk factors is extremely important. The common method of diagnosis is transthoracic echocardiography, but cardiac magnetic resonance (CMR) imaging represents “gold standard” in the evaluation of HCM patients. Treatment includes pharmacological therapy, surgery, alcohol ablation, and not least SCD prevention.
Literature
3.
go back to reference Barry J, Macron MS, Olivotto I (2019) Hypertrophic cardiomyopathy. In: Zipes DP, Peter L, Bonow RO, Mann DL, Tomaselli GF, Braunwald E (eds) Braunwald’s Heart Disease. A Textbook of Cardiovascular Medicine, 11th edn. Elsevier/Saunders, Philadelphia, pp 1602–1616 Barry J, Macron MS, Olivotto I (2019) Hypertrophic cardiomyopathy. In: Zipes DP, Peter L, Bonow RO, Mann DL, Tomaselli GF, Braunwald E (eds) Braunwald’s Heart Disease. A Textbook of Cardiovascular Medicine, 11th edn. Elsevier/Saunders, Philadelphia, pp 1602–1616
8.
go back to reference Rosca M, Popescu B (2017) Cardiomiopatia hipertrofica. In: Ginghina C (ed) Mic tratat de cardiologie, 2nd edn. Editura Academiei Romane, Bucuresti, pp 399–414 Rosca M, Popescu B (2017) Cardiomiopatia hipertrofica. In: Ginghina C (ed) Mic tratat de cardiologie, 2nd edn. Editura Academiei Romane, Bucuresti, pp 399–414
9.
go back to reference Gersh BJ, Maron BJ, Bonow RO et al (2011) 2011ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. https://doi.org/10.1016/j.jacc.2011.10.825 Gersh BJ, Maron BJ, Bonow RO et al (2011) 2011ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. https://​doi.​org/​10.​1016/​j.​jacc.​2011.​10.​825
10.
go back to reference Yuan CC, Kazmierczak K, Liang J et al (2017) Hypercontractile mutant of ventricular myosin essential light chain leads to disruption of sarcomeric structure and function and results in restrictive cardiomyopathy in mice. Cardiovasc Res. https://doi.org/10.1093/cvr/cvx060 Yuan CC, Kazmierczak K, Liang J et al (2017) Hypercontractile mutant of ventricular myosin essential light chain leads to disruption of sarcomeric structure and function and results in restrictive cardiomyopathy in mice. Cardiovasc Res. https://​doi.​org/​10.​1093/​cvr/​cvx060
12.
go back to reference Nagueh SF, Bierig SM, Budoff MF et al (2011) American Society of Echocardiography clinical recommendations for multimodalitycardiovascular imaging of patients with hypertrophic cardiomyopathy: endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Magnetic Resonance, and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. https://doi.org/10.1016/j.echo.2011.03.006 Nagueh SF, Bierig SM, Budoff MF et al (2011) American Society of Echocardiography clinical recommendations for multimodalitycardiovascular imaging of patients with hypertrophic cardiomyopathy: endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Magnetic Resonance, and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. https://​doi.​org/​10.​1016/​j.​echo.​2011.​03.​006
27.
go back to reference Kelly BS, Mattu A, Brady WJ (2007) Hypertrophic cardiomyopathy: electrocardiographic manifestations and other important considerations for the emergency physician. Am J Emerg Med 25(1):72–79CrossRef Kelly BS, Mattu A, Brady WJ (2007) Hypertrophic cardiomyopathy: electrocardiographic manifestations and other important considerations for the emergency physician. Am J Emerg Med 25(1):72–79CrossRef
44.
go back to reference Ellims AH, Iles LM, Ling LH, Hare JL, Kaye DM, Taylor AJ (2012) Diffuse myocardial fibrosis in hypertrophic cardiomyopathy can be identified by cardiovascular magnetic resonance, and is associated with left ventricular diastolic dysfunction. J Cardiovasc Magn Reson. https://doi.org/10.1186/1532-429X-14-76 Ellims AH, Iles LM, Ling LH, Hare JL, Kaye DM, Taylor AJ (2012) Diffuse myocardial fibrosis in hypertrophic cardiomyopathy can be identified by cardiovascular magnetic resonance, and is associated with left ventricular diastolic dysfunction. J Cardiovasc Magn Reson. https://​doi.​org/​10.​1186/​1532-429X-14-76
47.
go back to reference Urbano-Moral JA, Gutierrez-Garcia-Moreno L, Rodrigues-Palomares JF et al (2019) Structural abnormalities in hypertrophic cardiomyopathy beyond left ventricular hypertrophy by multimodality imaging evaluation. Echocardiography. https://doi.org/10.1111/echo.14393 Urbano-Moral JA, Gutierrez-Garcia-Moreno L, Rodrigues-Palomares JF et al (2019) Structural abnormalities in hypertrophic cardiomyopathy beyond left ventricular hypertrophy by multimodality imaging evaluation. Echocardiography. https://​doi.​org/​10.​1111/​echo.​14393
48.
go back to reference Patel P, Dhillon A, Popovic ZB et al (2015) Left ventricular outflow tract obstruction in hypertrophic cardiomyopathy patients without severe septal hypertrophy: implications of mitral valve and papillary muscle abnormalities assessed using cardiac magnetic resonance and echocardiography. Circ Cardiovasc Imaging. https://doi.org/10.1161/CIRCIMAGING.115.003132 Patel P, Dhillon A, Popovic ZB et al (2015) Left ventricular outflow tract obstruction in hypertrophic cardiomyopathy patients without severe septal hypertrophy: implications of mitral valve and papillary muscle abnormalities assessed using cardiac magnetic resonance and echocardiography. Circ Cardiovasc Imaging. https://​doi.​org/​10.​1161/​CIRCIMAGING.​115.​003132
49.
go back to reference Elliott PM, Anastasakis A, Borger MA et al (2014) 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. https://doi.org/10.1093/eurheartj/ehu284 Elliott PM, Anastasakis A, Borger MA et al (2014) 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. https://​doi.​org/​10.​1093/​eurheartj/​ehu284
71.
72.
go back to reference Singh K, Qutub M, Carson K, Hibbert B, Glover C (2016) A meta analysis of current status of alcohol septal ablation and surgical myectomy for obstructive hypertrophic cardiomyopathy. Catheter Cardiovasc Interv. https://doi.org/10.1002/ccd.26293 Singh K, Qutub M, Carson K, Hibbert B, Glover C (2016) A meta analysis of current status of alcohol septal ablation and surgical myectomy for obstructive hypertrophic cardiomyopathy. Catheter Cardiovasc Interv. https://​doi.​org/​10.​1002/​ccd.​26293
Metadata
Title
Phenotypes of hypertrophic cardiomyopathy: genetics, clinics, and modular imaging
Authors
Ioana Danuta Muresan
Lucia Agoston-Coldea
Publication date
01-09-2021
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 5/2021
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-020-09931-1

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