Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024
Autor(a) principal: | |
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Data de Publicação: | 2024 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | preprint |
Idioma: | por |
Título da fonte: | SciELO Preprints |
Texto Completo: | https://preprints.scielo.org/index.php/scielo/preprint/view/8394 |
Resumo: | Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation. |
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Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024cardiomiopatia hipertróficaCardiomiopatiasmétodos de imagemanálise genéticaHypertrophic cardiomyopathyCardiomyopathiesimaging methodsgenetic analysisHypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE. Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).SciELO PreprintsSciELO PreprintsSciELO Preprints2024-04-08info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/839410.1590/SciELOPreprints.8394porhttps://preprints.scielo.org/index.php/scielo/article/view/8394/15829Copyright (c) 2024 Fabio Fernandes, Marcus V. Simões, Edileide de Barros Correia, Fabiana G. Marcondes-Braga, Otavio Rizzi Coelho-Filho, Cláudio Tinoco Mesquita, Wilson Mathias-Junior, Carlos Eduardo Rochitte, Felix José Alvarez Ramires, Silvia Marinho Martins Alves, Marcelo Westerlund Montera, Renato Delascio Lopes, Mucio Tavares Oliveira-Junior, Fernando L. Scolari, Walkiria Samuel Avila, Manoel Fernandes Canesin, Fernando Bacal, Edimar Alcides Bocchi, Lídia Ana Zytynski Moura, Eduardo Benchimol Saad, Mauricio I. Scanavacca, Bruno Pereira Valdigem, Manuel Nicolas Cano , Alexandre Abizaid , Henrique Barbosa Ribeiro, Pedro Alves Lemos-Neto, Gustavo Calado de Aguiar Ribeiro, Fabio Biscegli Jatene, Ricardo Ribeiro Dias, Luis Beck-da-Silva, Luis Eduardo P. Rohde, Marcelo Imbroinise Bittencourt, Alexandre Pereira, José Eduardo Krieger, Humberto Villacorta, Wolney de Andrade Martins, José Albuquerque de Figueiredo-Neto, Juliano Novaes Cardoso , Carlos Alberto Pastore, Ieda Biscegli Jatene, Ana Cristina Sayuri Tanaka, Viviane Tiemi Hotta, Minna Moreira Dias Romano, Denilson Campos de Albuquerque, Ricardo Mourilhe-Rocha, Ludhmila Abrahão Hajjar, Fabio Sandoli de Brito, Bruno Caramelli , Daniela Calderaro, Pedro Silvio Farsky, Alexandre Siciliano Colafranceschi , Ibraim Masciarelli Pinto, Marcelo Luiz Campos Vieira , Luiz Claudio Danzmann, Silvio Henrique Barberato , Charles Mady, Martino Martinelli-Filho, Ana Flavia Malheiros Torbey , Pedro Vellosa Schwartzmann, Ariane Vieira Scarlatelli Macedo, Silvia Moreira Ayub Ferreira , Andre Schmidt, Marcelo Dantas Tavares de Melo , Moysés Oliveira Lima-Filho, Andrei C. Sposito, Flavio de Souza Brito, Andreia Biolo, Vagner Madrini-Junior, Stéphanie Itala Rizk, Evandro Tinoco Mesquitahttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessFernandes, FabioSimões, Marcus V.Correia, Edileide de BarrosMarcondes-Braga, Fabiana G.Coelho-Filho, Otavio RizziMesquita, Cláudio TinocoMathias-Junior, WilsonAntunes, MurilloArteaga-Fernández, EdmundoRochitte, Carlos EduardoRamires, Felix José AlvarezAlves, Silvia Marinho MartinsMontera, Marcelo WesterlundLopes, Renato DelascioOliveira-Junior, Mucio TavaresScolari, Fernando L.Avila, Walkiria SamuelCanesin, Manoel FernandesBocchi, Edimar AlcidesBacal, FernandoMoura, Lídia Ana ZytynskiSaad, Eduardo BenchimolScanavacca, Mauricio I.Valdigem, Bruno PereiraCano , Manuel NicolasAbizaid , AlexandreRibeiro, Henrique BarbosaLemos-Neto, Pedro AlvesRibeiro, Gustavo Calado de AguiarJatene, Fabio BiscegliDias, Ricardo RibeiroBeck-da-Silva, LuisRohde, Luis Eduardo P.Bittencourt, Marcelo ImbroinisePereira, AlexandreKrieger, José EduardoVillacorta, HumbertoMartins, Wolney de AndradeFigueiredo-Neto, José Albuquerque deCardoso , Juliano NovaesPastore, Carlos AlbertoJatene, Ieda BiscegliTanaka, Ana Cristina SayuriHotta, Viviane TiemiRomano, Minna Moreira DiasAlbuquerque, Denilson Campos deMourilhe-Rocha, RicardoHajjar, Ludhmila AbrahãoBrito, Fabio Sandoli deCaramelli , BrunoCalderaro, DanielaFarsky, Pedro SilvioColafranceschi , Alexandre SicilianoPinto, Ibraim MasciarelliVieira , Marcelo Luiz CamposDanzmann, Luiz ClaudioBarberato , Silvio HenriqueMady, CharlesMartinelli-Filho, MartinoTorbey , Ana Flavia MalheirosSchwartzmann, Pedro VellosaMacedo, Ariane Vieira ScarlatelliFerreira , Silvia Moreira AyubSchmidt, AndreMelo , Marcelo Dantas Tavares deLima-Filho, Moysés OliveiraSposito, Andrei C.Brito, Flavio de SouzaBiolo, AndreiaMadrini-Junior, VagnerRizk, Stéphanie ItalaMesquita, Evandro Tinocoreponame:SciELO Preprintsinstname:Scientific Electronic Library Online (SCIELO)instacron:SCI2024-04-08T13:15:47Zoai:ops.preprints.scielo.org:preprint/8394Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2024-04-08T13:15:47SciELO Preprints - Scientific Electronic Library Online (SCIELO)false |
dc.title.none.fl_str_mv |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 Diretriz sobre Diagnóstico e Tratamento da Cardiomiopatia Hipertrófica – 2024 |
title |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 |
spellingShingle |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 Fernandes, Fabio cardiomiopatia hipertrófica Cardiomiopatias métodos de imagem análise genética Hypertrophic cardiomyopathy Cardiomyopathies imaging methods genetic analysis |
title_short |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 |
title_full |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 |
title_fullStr |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 |
title_full_unstemmed |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 |
title_sort |
Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy – 2024 |
author |
Fernandes, Fabio |
author_facet |
Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Antunes, Murillo Arteaga-Fernández, Edmundo Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bocchi, Edimar Alcides Bacal, Fernando Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco |
author_role |
author |
author2 |
Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Antunes, Murillo Arteaga-Fernández, Edmundo Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bocchi, Edimar Alcides Bacal, Fernando Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Fernandes, Fabio Simões, Marcus V. Correia, Edileide de Barros Marcondes-Braga, Fabiana G. Coelho-Filho, Otavio Rizzi Mesquita, Cláudio Tinoco Mathias-Junior, Wilson Antunes, Murillo Arteaga-Fernández, Edmundo Rochitte, Carlos Eduardo Ramires, Felix José Alvarez Alves, Silvia Marinho Martins Montera, Marcelo Westerlund Lopes, Renato Delascio Oliveira-Junior, Mucio Tavares Scolari, Fernando L. Avila, Walkiria Samuel Canesin, Manoel Fernandes Bocchi, Edimar Alcides Bacal, Fernando Moura, Lídia Ana Zytynski Saad, Eduardo Benchimol Scanavacca, Mauricio I. Valdigem, Bruno Pereira Cano , Manuel Nicolas Abizaid , Alexandre Ribeiro, Henrique Barbosa Lemos-Neto, Pedro Alves Ribeiro, Gustavo Calado de Aguiar Jatene, Fabio Biscegli Dias, Ricardo Ribeiro Beck-da-Silva, Luis Rohde, Luis Eduardo P. Bittencourt, Marcelo Imbroinise Pereira, Alexandre Krieger, José Eduardo Villacorta, Humberto Martins, Wolney de Andrade Figueiredo-Neto, José Albuquerque de Cardoso , Juliano Novaes Pastore, Carlos Alberto Jatene, Ieda Biscegli Tanaka, Ana Cristina Sayuri Hotta, Viviane Tiemi Romano, Minna Moreira Dias Albuquerque, Denilson Campos de Mourilhe-Rocha, Ricardo Hajjar, Ludhmila Abrahão Brito, Fabio Sandoli de Caramelli , Bruno Calderaro, Daniela Farsky, Pedro Silvio Colafranceschi , Alexandre Siciliano Pinto, Ibraim Masciarelli Vieira , Marcelo Luiz Campos Danzmann, Luiz Claudio Barberato , Silvio Henrique Mady, Charles Martinelli-Filho, Martino Torbey , Ana Flavia Malheiros Schwartzmann, Pedro Vellosa Macedo, Ariane Vieira Scarlatelli Ferreira , Silvia Moreira Ayub Schmidt, Andre Melo , Marcelo Dantas Tavares de Lima-Filho, Moysés Oliveira Sposito, Andrei C. Brito, Flavio de Souza Biolo, Andreia Madrini-Junior, Vagner Rizk, Stéphanie Itala Mesquita, Evandro Tinoco |
dc.subject.por.fl_str_mv |
cardiomiopatia hipertrófica Cardiomiopatias métodos de imagem análise genética Hypertrophic cardiomyopathy Cardiomyopathies imaging methods genetic analysis |
topic |
cardiomiopatia hipertrófica Cardiomiopatias métodos de imagem análise genética Hypertrophic cardiomyopathy Cardiomyopathies imaging methods genetic analysis |
description |
Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation. |
publishDate |
2024 |
dc.date.none.fl_str_mv |
2024-04-08 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/preprint info:eu-repo/semantics/publishedVersion |
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preprint |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://preprints.scielo.org/index.php/scielo/preprint/view/8394 10.1590/SciELOPreprints.8394 |
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https://preprints.scielo.org/index.php/scielo/preprint/view/8394 |
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10.1590/SciELOPreprints.8394 |
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https://preprints.scielo.org/index.php/scielo/article/view/8394/15829 |
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