From the Research
The MAYO score is not used for diagnosing hypertrophic obstructive cardiomyopathy (HOCM), but rather for risk stratification of patients already diagnosed with this condition. The MAYO score helps predict the risk of sudden cardiac death in HOCM patients, which guides decisions about preventive interventions such as implantable cardioverter-defibrillator (ICD) placement.
Key Components of the MAYO Score
The score incorporates several clinical variables including:
- Age
- Family history of sudden cardiac death
- Unexplained syncope
- Left ventricular outflow tract gradient
- Maximum left ventricular wall thickness
- Left atrial diameter
- Presence of non-sustained ventricular tachycardia Each factor is assigned points, and the total score estimates the 5-year risk of sudden cardiac death. For example, a score of 6 or higher typically indicates high risk (>6% 5-year risk), which might warrant ICD implantation 1.
Diagnosis of HOCM
The actual diagnosis of HOCM relies on different criteria, primarily echocardiographic findings showing asymmetric septal hypertrophy with left ventricular wall thickness ≥15 mm (or ≥13 mm with family history), along with clinical symptoms, electrocardiographic changes, and sometimes genetic testing. Understanding this distinction is important for proper patient management, as misapplying the MAYO score for diagnostic purposes rather than risk assessment could lead to inappropriate clinical decisions.
Recent Guidelines and Recommendations
Recent studies, such as the one published in 2024 2, emphasize the importance of proper diagnosis and risk stratification in managing HOCM, highlighting the role of pharmacotherapy, septal reduction treatments, and management of sequelae like atrial fibrillation and malignant arrhythmias.
Clinical Implications
In clinical practice, the MAYO score should be used judiciously, considering the individual patient's risk factors and clinical presentation, to guide decisions about preventive interventions and management strategies, as supported by recent evidence 3, 4.