Familial Hypertrophic Cardiomyopathy: Diagnosis and Management

Michael J Litt,1 Ayan Ali,2 Nosheen Reza1 1Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 2Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USACorrespondence: Nosheen Reza, Perelman School of Medicine at the University of Pennsylvania, Department of Medicine, 3400 Civic Center Boulevard, 11th Floor South Pavilion, Philadelphia, PA, 19104, USA, Tel +1 215 615 0044, Fax +1 215 615 1263, Email nosheen.reza@pennmedicine.upenn.eduAbstract: 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