Treatment of hypertrophic cardiomyopathy
Authors:
J. Veselka
Published in:
Kardiol Rev Int Med 2005, 7(3): 165-168
Overview
Hypertrofic cartiomyopathy (HCM) is a heterogeneous disease with a relatively high prevalence with potentially adverse development in some groups of patients. After stating diagnosis the main task of the doctor is to stratify patient’s risk with the help of anamnesis and non-invasive cardiology check-up. An implantation of cardioverter-defibrillator is indicated in a group of high-risk patients. Asymptomatic patients are monitored in the long term; symptomatic patients are given beta blockers or verapamil. On symptomatical patients with obstructive form of HCM - on those that medicament treatment did not subdue the symptoms - surgical myectomy, alcohol septal ablation or in a special case biventricular cardiostimulation can be performed.<0}
Key words:
Hypertrophic cardiomyopathy – therapy – cardiostimulation – myectomy – septal ablation
Sources
1. Elliott P, McKenna WJ. Hypertrophic cardiomyopathy. Lancet 2004; 363: 1881-91.
2. Maron BJ, McKenna WJ, Danielson GK et al. ACC/ESC clinical expert consensus document on hypertrophic cardiomyopathy. Eur Heart J 2003; 24: 1965-91.
3. Maron BJ, Spirito P. Impact of patient selection biases on the perception of hypertrophic cardiomyopathy. J Am Coll Cardiol 2003; 41: 974-80.
4. Maron BJ. Hypertrophic cardiomyopathy. Lancet 1997; 350: 127-33.
5. Maron BJ. Hypertrophic cardiomyopathy. A systematic review. JAMA 2002; 287: 1308-20.
6. Maron MS, Olivotto I, Betocchi S et al. Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med 2003; 348: 295-303.
7. Watkins H. Sudden death in hypertrophic cardiomyopathy. N Engl J Med 2000; 372: 422-3.
8. Spirito P, Seidman CE, McKenna WJ, Maron BJ. Management of hypertrophic cardiomyopathy. N Engl J Med 1997; 336: 775-85.
9. Morrow AG, Reitz BA, Epstein SE et al. Operative treatment in hypertrophic subaortic stenosis: techniques, and the results of pre and postoperative assessment in 83 patients. Circulation 1975; 52: 88-102.
10. Heric B, Lytle BW, Miller DP, Rosenkranz ER, Lever HM, Cosgrove DM. Surgical management of hypertrophic obstructive cardiomyopathy: early and late results. J Thorac Cardiovasc Surg 1995; 110: 196-208.
11. McCully RB, Nishimura RA, Tajik AJ et al. Extent of clinical improvement after surgical treatment of hypertrophic obstructive cardiomyopathy. Circulation 1996; 94: 467-71.
12. Maron BJ, Nishimura RA, Danielson GK. Pitfalls in clinical recognition and a novel operative approach for hypertrophic cardiomyopathy with severe outflow obstruction due to anomalous papillary muscle. Circulation 1998; 98: 2505-8.
13. Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet 1995; 346: 211-4.
14. Seggewiss H. Percutaneous transluminal septal myocardial ablation: A new treatment for hypertrophic obstructive cardiomyopathy. Eur Heart J 2000; 21: 704-7.
15. Veselka J, Duchoňová R, Procházková Š, Páleníčková J, Sorajja P, Tesař D. Effects of varying ethanol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy on early hemodynamic changes. Am J Cardiol 2005; 95: 675-8.
16. Veselka J, Procházková Š, Duchoňová R et al. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: Lower alcohol dose reduces size of infarction and has comparable hemodynamic and clinical outcome. Catheter Cardiovasc Interv 2004; 64: 231-5.
17. Veselka J, Honěk T. Early remodelling of left ventricle and improvement of myocardial performance in patients after percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy. Int J Cardiol 2003; 88: 27-32.
18. Linde C, Gadler F, Kappenberger L, Rydén L. Placebo effect of pacemaker implantation in obstructive hypertrophic cardiomyopathy. PIC Study Group. Pacing In Cardiomyopathy. Am J Cardiol 1999; 83: 903-7.
19. Maron BJ, Nishimura RA, McKenna WJ, et al. Assessment of permanent dual-chamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY). Circulation 1999; 99: 2927-33.
Labels
Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2005 Issue 3
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