Optimizing the management of HCM
Regular monitoring and evaluation are recommended for patients with hypertrophic cardiomyopathy (HCM)1,2
Patients should be monitored and evaluated at a frequency that is determined by the severity of their disease, age and symptoms.1,2*
Recommended approaches to monitoring and evaluation
Echocardiography1
In patients with no change in clinical status or events, atransthoracic echocardiogram should be performed every 1 to 2 years to assess degree of myocardial hypertrophy, dynamic LVOTO, MR and myocardial function
Repeat echocardiogram is recommended for patients with a change in clinical status or new clinical event
For patients with resting peak LVOT gradient <50 mmHg, echocardiogram with provocative maneuvers is recommended
Holter monitor1,3
24-hour ambulatory (Holter) electrocardiogram is recommended every 1 to 2 years in patients with HCM who have no previous evidence of ventricular tachycardia
Cardiopulmonary exercise testing1,3
Includes parameters such as ventilatory efficiency and anaerobic threshold with simultaneous measurement of respiratory gases (e.g., peak oxygen consumption [pVO2])
Can provide objective evidence for worsening disease and may be considered every 2 to 3 years
Other measures to evaluate treatment and follow patients with symptomatic HCM/obstructive HCM include:
- Left ventricular outflow tract (LVOT) gradient1,3
- Reduction in physical limitations1
- Symptomatic improvement3
HCM can continue to progress
even in asymptomatic patients1,2
Monitoring is recommended and should increase in frequency based on symptoms, age and severity of disease1-3
Ongoing monitoring and evaluation of patients
can determine if HCM is progressing1-3
References
- Ommen SR, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2024;83(23):2324-405.
- Crean AM, et al. General Clinical Practice Update: Canadian Cardiovascular Society Clinical Practice Update on Contemporary Management of the Patient with Hypertrophic Cardiomyopathy. Can J Cardiol 2024;40(9):1503-23.
- Naidu, Srihari S, editor. Hypertrophic Cardiomyopathy. Second ed., Springer International Publishing, 2019.