ECHO 2013 / Hypertrophic Cardiomyopathy
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Hypertrophic Cardiomyopathy
Mario J Garcia, MD
Diagnosis and Management
Disclosure Statement of Financial Interest
Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the organization(s) listed below.
Affiliation/Financial Relationship |
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Grant/Research Support |
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none |
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Consulting Fees/Honoraria |
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WebMD |
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Major Stock Shareholder/Equity |
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Pfizer |
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Royalty Income |
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Elsevier, Lippincott |
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Ownership/Founder |
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none |
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Intellectual Property Rights |
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none |
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Other Financial Benefit |
• |
none |
Imaging in Hypertrophic
Cardiomyopathy
•Diagnosis
•Evaluation of Symptoms
•Screening
•Therapy Guidance
Risk of Sudden Cardiac Death
Relief of LVOT obstruction
Imaging in Hypertrophic
Cardiomyopathy
•Diagnosis
•Evaluation of Symptoms
•Screening
•Therapy Guidance
Risk of Sudden Cardiac Death
Relief of LVOT obstruction
HCM
•Primary ventricular hypertrophy
•Prevalence 0.2-0.5%
•Hereditary in 30-50%
•Autosomic dominant in 80%
•Age related variable penetrance
•Annual SCD 1-2% adults, 4-6% in younger
Genetic Testing in HCM
Boss, J Am Coll Cardiol 2009;54:201-11
Genetic Testing in HCM
Boss, J Am Coll Cardiol 2009;54:201-11
HCM
Pathophysiology
Maron, J Am Coll Cardiol 2009, 54:866-75
IVS thickness (cm)
Abnormal
Strain in HCM
3.5 |
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3 |
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2.5 |
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2 |
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1.5 |
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1 |
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y = 0.03x + 2.48 |
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r = 0.54 |
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0.5 |
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p < 0.01 |
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0 |
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-20 |
-10 |
0 |
10 |
20 |
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Strain (%) in the mid anterior septum
Yang, J Am Soc Echocardiogr, 2003
HOCM
vs Hypertrophy of the Athlete
Maron, NEJM 1991;324:295