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Diagnosis, treatment, and follow-up management of HCM, the current situation and future of Asia-Pacific China.
Hypertrophic cardiomyopathy (HCM) is a hereditary cardiomyopathy characterized by myocardial hypertrophy. It is currently the most common hereditary heart disease in clinical practice. HCM is a global disease, and HCM has been reported in more than 50 countries [2]. The adult prevalence of HCM in European and American countries is about 0.2% [3]. The current survey in my country shows that the prevalence is 0.18%, and the total number of patients exceeds 1 million [3].
HCM is a heart disease with high clinical manifestations. Some patients may have no symptoms, and the life expectancy of these patients is not statistically different from that of normal people. [4]. Another patient, especially obstructive HCM patients, will have excessive pressure due to the rapid blood flow through the narrow left ventricular outflow tract when the left ventricle is contracted, which will aggravate the obstruction, and cause precardial discomfort, chest tightness, , chest pain, dyspnea, fainting and even sudden death. Therefore, standardized management of HCM has always been a major problem for cardiologists. The management of
HCM mainly includes three parts: diagnosis, treatment, and long-term follow-up. At present, the clinical diagnosis of HCM mainly relies on echocardiography. Usually, HCM can be diagnosed as diastolic ventricular septal thickness of 15mm or above. However, some familial or sporadic HCM patients with HCM need to know in detail about family history, electrocardiogram, other imaging examinations and non-cardiovascular clinical manifestations before clarifying the diagnosis. Secondly, left ventricular hypertrophy may occur, such as abnormal increase in cardiac load or secondary to metabolic disorders or hereditary diseases. However, myocardial hypertrophy caused by these diseases is different from HCM in terms of pathological properties, so it is important to emphasize a comprehensive differential diagnosis of myocardial hypertrophy. In terms of
treatment, the current management guidelines point out that the treatment goal of HCM is to improve cardiac function, relieve clinical symptoms, and delay disease progression [5]. Drugs are the basis of HCM treatment, but the choice and priority of drugs vary in patients with clinical symptoms or left ventricular outflow obstruction (LVOTO). Secondly, clinicians should also carefully evaluate whether non-drug treatments such as intervention and or surgical procedures.
Finally, follow-up, HCM is the most common cause of sudden cardiac death in young people and athletes. Management guidelines recommend that HCM patients require lifelong follow-up to monitor the risk of symptom changes, adverse cardiovascular events, arrhythmia, , etc. [5]. Prevent sudden cardiac death (SCD) in HCM patients.
In recent years, due to the rapid development of gene sequencing technology, more than 25 related pathogenic genes [6] have been identified. Therefore, gene detection , targeted therapy, etc. are gradually becoming the focus of HCM disease management, and more information is also needed to confirm their relationship.
In order to continue to improve the clinical diagnosis and treatment level of HCM in my country, promote the standardized management of HCM patients, and enable HCM patients to gain more life and survival benefits, Liantuo Bio's cardiovascular medicine affairs team jointly with the "medical community" media to create an online series of meetings of " hypertrophic cardiomyopathy Cloud College". From August to December 2022, experts in the cardiovascular field will be invited every month to discuss how to optimize the diagnosis and treatment standards of HCM based on the pathogenesis, disease management, and treatment progress of HCM. The third session of
will be held in the form of live broadcast on October 11, 2022, and will be invited to serve as the chairman of the conference. Professor Dong Hugang, First Affiliated Hospital of Sun Yat-sen University, Professor Chen Xuechao of Singapore Novena Heart Center, Professor Wu Zhiming of National Taiwan University Hospital, and Professor Wu Zhiming of National Taiwan University Hospital, and Professor Yang Zhiming of the diagnosis and treatment of HCM in Asia-Pacific and China, genetic testing to assist patient follow-up, and management of the entire disease course of the disease. Then, Shandong University Qilu Hospital Bu Peili , Zhejiang Jiang Provincial Hospital of Traditional Chinese Medicine Mao Wei , Southern Medical University Southern Hospital Professor Bin Jianping, Sun Yat-sen University Sun Yixian Memorial Hospital Professor Chen Yangxin, Tianjin Chest Hospital Cong Hongliang Professor , , and , , shared and discussed the academic progress of HCM.Work together to provide more scientific guidance and improvement in disease management and treatment choices, thereby benefiting more HCM patients.
Third session time :
2022htmlOctober 11, 7 19:30-22:00
Meeting specific schedule
References:
[1]Wang Juan, Yang Yanmin. Research progress on risk factors and management strategies for hypertrophic cardiomyopathy [J]. Progress in Cardiology, 2021, 42(07):582-585.DOI:10.16806/j.cnki.issn.1004-3934.2021.07.002.
[2]Maron BJ, Gardin JM, Flack JM, Gidding SS, Kurosaki TT, Bild DE. Prevalence of hypertrophic cardiomypathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA Study. Coronary Artery Risk Development in (Young) Adults. Circulation. 1995 Aug 15;92(4):785-9. doi: 10.1161/01.cir.92.4.785. PMID: 7641357.
[3]Zou Y, Song L, Wang Z, Ma A, Liu T, Gu H, Lu S, Wu P, Zhang dagger Y, Shen dagger L, Cai Y, Zhen double dagger Y, Liu Y, Hui R. Prevalence of idiopathic hypertrophic cardiomypathy in China: a population-based echocardiographic analysis of 8080 adults. Am J Med. 2004 Jan 1;116(1):14-8. doi: 10.1016/j.amjmed.2003.05.009. PMID: 14706660.
[4]Spirito P, Seidman CE, McKenna WJ, Maron BJ. The management of hyperphic cardiomypathy. N Engl J Med. 1997 Mar 13;336(11):775-85. doi: 10.1056/NEJM199703133361107. PMID: 9052657.
[5] Guidelines for the Management of Hypertrophic Cardiomyopathy in China 2017[J]. Chinese Journal of Heart Failure and Cardiomyopathy, 2017(02):65-66-67-68-69-70-71-72-73-74-75-76-77-78-79-80-81-82-83-84-85-86.
[6] Liu Wenling ,Hu Dayi. Molecular genetic diagnosis and risk stratification of hypertrophic cardiomyopathy [J]. Chinese Journal of Cardiac Pacing and Electrophysiology, 2004(05):71-72.DOI:10.13333/j.cnki.cjcpe.2004.05.024.
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