Hypertrophic Cardiomyopathy: Current Treatment and Future Options

Sebastian, Sneha Annie; Panthangi, Venkatesh; Singh, K.K.; Rayaroth, Swetha; Gupta, Aditi; Shantharam, Darshan; Rasool, Banan Qasim; Padda, Inderbir; Co, Edzel Lorraine; Johal, Gurpreet

doi:10.1016/j.cpcardiol.2022.101552

Cited by 10 publications

(9 citation statements)

References 128 publications

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“…Echocardiography is pivotal as the primary diagnostic and monitoring tool in HCM [29]. M-mode, 2D, and Doppler transthoracic echocardiography (TTE) are commonly employed techniques, while strain imaging and 3D can help to detect subtle changes in early phenotypes.…”

Section: Clinical Diagnosis and Imaging Toolsmentioning

confidence: 99%

“…The management of HCM requires a collaborative approach, where the patient and the healthcare team work together harmoniously [29]. This partnership entails the active involvement of the patient and relatives in decision-making processes, ensuring their understanding of the benefits, risks, action plans, and ultimate goals concerning their condition.…”

Section: Sudden Cardiac Death Risk Assessment and Preventionmentioning

confidence: 99%

“…Diltiazem and verapamil are the most common drugs of this class [29]. Their efficacy is similar to BBs in reducing symptoms [52].…”

Section: Calcium Channel Blockersmentioning

confidence: 99%

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Revisiting Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Current Practice and Novel Perspectives

Ottaviani,

Mansour,

Molinari

et al. 2023

JCM

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Sarcomeric hypertrophic cardiomyopathy (HCM) is a prevalent genetic disorder characterised by left ventricular hypertrophy, myocardial disarray, and an increased risk of heart failure and sudden cardiac death. Despite advances in understanding its pathophysiology, treatment options for HCM remain limited. This narrative review aims to provide a comprehensive overview of current clinical practice and explore emerging therapeutic strategies for sarcomeric HCM, with a focus on cardiac myosin inhibitors. We first discuss the conventional management of HCM, including lifestyle modifications, pharmacological therapies, and invasive interventions, emphasizing their limitations and challenges. Next, we highlight recent advances in molecular genetics and their potential applications in refining HCM diagnosis, risk stratification, and treatment. We delve into emerging therapies, such as gene editing, RNA-based therapies, targeted small molecules, and cardiac myosin modulators like mavacamten and aficamten, which hold promise in modulating the underlying molecular mechanisms of HCM. Mavacamten and aficamten, selective modulators of cardiac myosin, have demonstrated encouraging results in clinical trials by reducing left ventricular outflow tract obstruction and improving symptoms in patients with obstructive HCM. We discuss their mechanisms of action, clinical trial outcomes, and potential implications for the future of HCM management. Furthermore, we examine the role of precision medicine in HCM management, exploring how individualised treatment strategies, including exercise prescription as part of the management plan, may optimise patient outcomes. Finally, we underscore the importance of multidisciplinary care and patient-centred approaches to address the complex needs of HCM patients. This review also aims to encourage further research and collaboration in the field of HCM, promoting the development of novel and more effective therapeutic strategies, such as cardiac myosin modulators, to hopefully improve the quality of life and outcome of patients with sarcomeric HCM.

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Section: Clinical Diagnosis and Imaging Toolsmentioning

confidence: 99%

Section: Sudden Cardiac Death Risk Assessment and Preventionmentioning

confidence: 99%

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Revisiting Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Current Practice and Novel Perspectives

Ottaviani,

Mansour,

Molinari

et al. 2023

JCM

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“…The introduction of the cardiovascular-kidney-metabolic (CKM) syndrome concept provides a new framework for understanding the complex interplay between cardiometabolic syndrome and CKD [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Cardiometabolic Risk Phenotypes and Chronic Kidney Disease Incidence in Older Adults：A Nationwide Longitudinal Cohort Study

Zeng,

Xiao

2024

Preprint

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Background There is mixed evidence for an association between cardiometabolic risk factors and chronic kidney disease risk (CKD). This study aimed to determine whether different latent classes of cardiometabolic conditions were associated with chronic kidney disease risk. Method Data from 7,195 participants in the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Latent class analysis was performed using data on obesity, high-density lipoprotein cholesterol, triglyceride, hypertension, diabetes, arthritis or rheumatism, and systemic inflammatory conditions and heart disease. Confounder-adjusted multiple logistic regressions were conducted to estimate CKD incidence by cardiometabolic latent classes. Results Three cardiometabolic classes were identified: relatively healthy cardiometabolic (RHC) phenotype, metabolic syndrome (MetS) phenotype, and cardiovascular disease (CVD) phenotype, which accounted for 66.2%, 19.9%, and 13.8%, respectively. The incidence of CKD was 12.7% in the CVD group, 9.4% in the MetS group, and 5.9% in the RHC group. After adjusting for confounding factors, it was found that the metabolic syndrome type had a 54% increased risk of newly diagnosed CKD compared to the healthy heart type (OR = 1.54, 95% CI: 1.22–1.93), while the cardiovascular type increased by 104% (OR = 2.04, 95% CI: 1.61–2.57). Conclusion Different cardiometabolic phenotypes are associated with an increased risk of new-onset CKD. Gender and age are important factors influencing the strength of this association.

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“…Usually, the patients diagnosed with cardiomyopathy by echocardiography or cardiovascular magnetic resonance have entered the middle or late stages of disease. At that time, the treatment measures mainly focused on improving the symptoms of heart failure and preventing malignant arrhythmia, which is difficult to achieve satisfactory efficacy [8,9]. Early genetic diagnostic markers and targeted therapy methods need to be further developed.…”

Section: Introductionmentioning

confidence: 99%

Integrated bioinformatics and experiment revealed that cuproptosis is the potential common pathogenesis of three kinds of primary cardiomyopathy

Wang,

Xu,

et al. 2023

Aging

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Cuproptosis is a recently reported new mode of programmed cell death which might be a potential copathogenesis of three kinds of primary cardiomyopathy. However, no investigation has reported a clear relevance between primary cardiomyopathy and cuproptosis. In this study, the differential cuproptosis-related genes (CRGs) shared by three kinds of primary cardiomyopathy were identified in training sets. As a result, four CRGs shared by three kinds of primary cardiomyopathy were acquired and they were mainly related to biological processes such as cell death and immuno-inflammatory response through differential analysis, correlation analysis, GSEA, GSVA and immune cell infiltration analysis. Then, three key CRGs (K-CRGs) with high diagnostic value were identified by LASSO regression. The results of nomogram, machine learning, ROC analysis, calibration curve and decision curve indicated that the K-CRGs exhibited outstanding performance in the diagnosis of three kinds of primary cardiomyopathy. After that, in each disease, two molecular subtypes clusters were distinguished. There were many differences between different clusters in the biological processes associated with cell death and immunoinflammation and K-CRGs had excellent molecular subtype identification efficacy. Eventually, results from validation datasets and in vitro experiments verified the role of K-CRGs in diagnosis of primary cardiomyopathy, identification of primary cardiomyopathic molecular subtypes and pathogenesis of cuproptosis. In conclusion, this study found that cuproptosis might be the potential common pathogenesis of three kinds of primary cardiomyopathy and K-CRGs might be promising biomarkers for the diagnosis and molecular subtypes identification of primary cardiomyopathy.

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Hypertrophic Cardiomyopathy: Current Treatment and Future Options

Cited by 10 publications

References 128 publications

Revisiting Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Current Practice and Novel Perspectives

Revisiting Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Current Practice and Novel Perspectives

Cardiometabolic Risk Phenotypes and Chronic Kidney Disease Incidence in Older Adults：A Nationwide Longitudinal Cohort Study

Integrated bioinformatics and experiment revealed that cuproptosis is the potential common pathogenesis of three kinds of primary cardiomyopathy

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