HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY

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Abstract

Hypertrophic cardiomyopathy (HCMP) is a relatively common disease with genetic predisposition, that is widely spread irrespective of gender, race or ethnicity. The cause of this pathology are mutations of genes encoding synthesis of contracting proteins. Degree and type of mutations define clinical manifestation of the disease and its prognosis. HCMP is classified according to four main criteria: depending on morphology, presence of left ventricular outlet obstruction, pressure gradient and hemodynamic parameters. Its prevalence amounts to 1:500, and in the recent years mortality has decreased significantly to 1%. Main symptoms of HCMP include dyspnoea, dizziness, syncope, angina, and heart arrhythmias. HCMP does not manifest obligatorily with all above mentioned signs and symptoms. Presence and severity of any symptoms depend on morphological particulars of the disease. Particular attention should be paid to arrhythmias, with atrial fibrillation among them, that may cause hazardous and occasionally lethal complications. Electrocardiography and echocardiography are recognized as the “golden standard” of HCMP diagnostics, while in the recent years, magnetic resonance imaging has become a highly informative diagnostic tool. Radionuclide diagnostics is used less frequently, while physical examination and assessments have been moving backwards. At present, main strategies in HCMP include medical treatment with β-blockers, calcium antagonists, angiotensin-converting enzyme inhibitors and anti-arrhythmics. There are two techniques for surgical treatment, i.e. myectomy by Morrow and alcohol septal ablation that is becoming increasingly popular. The article reviews literature on state-of-the-art diagnostics and treatment of HCMP patients.

About the authors

A. G. Osiev

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: osiev_ag@mail.ru

MD, PhD, Professor, Head of Department of Cardiovascular Surgery

Russian Federation

R. A. Naydenov

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: najden@bk.ru

Doctor, Specialist in Radioendovascular Diagnostics and Treatment of the Center for Interventional Cardiology

Russian Federation

E. I. Kretov

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

PhD, Leading Research Fellow, a Doctor Specialist in Radioendovascular Diagnostics and Treatment of the Center for Interventional Cardiology

Russian Federation

N. R. Obedinskaya

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

Doctor, Department of X-ray and Computer Tomography

Russian Federation

V. P. Kurbatov

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

PhD, Head of Department of X-ray and Computer Tomography

Russian Federation

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Copyright (c) 2015 Osiev A.G., Naydenov R.A., Kretov E.I., Obedinskaya N.R., Kurbatov V.P.

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