2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy

Abstract

Рабочая группа по диагностике и лечению гипертрофической кардиомиопатии Европейского общества кардиологов (ESC)Авторы/члены рабочей группы: perry M. Elliott* (Председатель) (великобритания) Aris Anastasakis (Греция), Michael A. borger (Германия), Martin borggrefe (Германия), Franco Cecchi (Италия), philippe Charron (Франция), Albert Alain Hagege (Франция), Antoine Lafont (Франция), Giuseppe Limongelli (Италия), Heiko Mahrholdt (Германия), William J. McKenna (великобритания), Jens Mogensen (дания), petros Nihoyannopoulos (великобритания), Stefano Nistri (Италия), petronella G. pieper (Нидерланды), burkert pieske (Австрия), Claudio Rapezzi (Италия), Frans H. Rutten (Нидерланды), Christoph Tillmanns (Германия), Hugh Watkins (великобритания). Дополнительный участник: Constantinos O'Mahony (великобритания).Комитет ESC по подготовке практических рекомендаций (КПР): Jose Luis Zamorano (Председатель) (Испания), Stephan Achenbach (Германия), Helmut baumgartner (Германия), Jeroen J. bax (Нидерланды), Héctor bueno (Испания), Veronica Dean (Франция), Christi Deaton (великобритания), Çetin Erol (Турция), Robert Fagard (Бельгия), Roberto Ferrari (Италия), David Hasdai (Израиль), Arno W. Hoes (Нидерланды), paulus Kirchhof (Германия/великобритания), Juhani Knuuti (Финляндия), philippe Kolh (Бельгия), patrizio Lancellotti (Бельгия), Ales Linhart (Чехия), petros Nihoyannopoulos (великобритания), Massimo F. piepoli (Италия), piotr ponikowski (Польша), per Anton Sirnes (Норвегия), Juan Luis Tamargo (Испания), Michal Tendera (Польша), Adam Torbicki (Польша), William Wijns (Бельгия), Stephan Windecker (Швейцария).Рецензенты: David Hasdai (Израиль) (КПР координатор рецензирования), piotr ponikowski (Польша) (КПР координатор рецензирования), Stephan Achenbach (Германия), Fernando Alfonso (Испания), Cristina basso (Италия), Nuno Miguel Cardim (Португалия), Juan Ramón Gimeno (Испания), Stephane Heymans (Нидерланды), per Johan Holm (Швеция), Andre Keren(Израиль), paulus Kirchhof (Германия/великобритания), philippe Kolh (Бельгия), Christos Lionis (Греция), Claudio Muneretto (Италия), Silvia priori (Италия), Maria Jesus Salvador (Испания), Christian Wolpert (Германия), Jose Luis Zamorano (Испания).Формы раскрытия конфликта интересов авторов и рецензентов рекомендаций доступны на сайте ESC www.escardio.org/guidelines

Septal reduction therapy using nonalcohol agent in hypertrophic obstructive cardiomyopathy: Single center experience

“…Compared with the ASA method, limited ischemic necrosis in the EVOH septal ablation procedure may cause a significant decrease in efficacy especially in patients with a septum thickness of 25 mm or more. Current guidelines emphasize the preference of surgical myectomy rather than ASA in patients with significant thick septum [1,2]. In our series, the septum thickness of our 3 patients was over 25 mm, and one of them was treated with surgical septal myectomy and mitral valve replacement.…”

“…In our study, we revealed a reduction in left atrium volume and volume index and this decline has continued throughout the follow-up. Therefore, showing the LV and LA reverse remodeling is one of the most important aspects of our work.ASA has a principal role in the current management of drugrefractory HOCM patients with LVOT obstruction and became the treatment of choice in most patients[2]. The main reason compelling us to use EVOH for septal ablation was to avoid remote infarction that may be noted after alcohol injection.…”

Importance of Sudden Cardiac Death Risk Stratification in Hypertrophic Cardiomyopathy

“…7 They found that previous algorithms based on binary variables did not take into account the effect size of individual risk factors, and so had a modest discriminatory power between high and low risk. Therefore, sudden cardiac death risk assessment using HCM Risk-SCD 8 is recommended.…”

How far do we want to go in the treatment of obstruction in Hypertrophic Cardiomyopathy?

“…The present clinical case illustrates several interesting clinical aspects related to natural history and management of left ventricular outflow tract obstruction: (1) the differential diagnosis between hypertensive heart with obstruction versus Hypertrophic Cardiomyopathy (HCM) [1]; (2) the difficulties involved in its medical treatment [2]; and (3) the temporary effect of the different strategies for reducing obstruction in HCM [3,4]. Finally the indication of invasive techniques can occasionally lead to iatrogenic effects particularly in the elderly patients.…”