New ESC guidelines on hypertrophic cardiomyopathy: new insights in invasive treatment?

Excerpt

Hypertrophic cardiomyopathy (HCM) is a complex, yet relatively common genetic cardiac disease and has been the subject of intensive investigation since its first description in 1958. HCM is defined by the presence of an increased left ventricular wall thickness that is not solely explained by abnormal loading conditions. Histologically, HCM is characterised as left ventricular hypertrophy due to an abnormally hypertrophied muscular structure of predominantly the septum (‘myocardial fibre disarray’) [1]. Approximately 30 % of patients with HCM develop left ventricular outflow tract (LVOT) obstruction under resting conditions [2‐4]. By convention, LVOT obstruction is defined as an instantaneous peak Doppler LVOT gradient of > 30 mmHg at rest or during physiological provocation. A gradient of > 50 mmHg is usually considered to be the threshold at which LVOT obstruction becomes haemodynamically significant. …