From the Guidelines
Neo does not have a direct role in helping with Hypertrophic Cardiomyopathy (HCM) as it is not a medical treatment or intervention, but rather a term that may refer to various concepts unrelated to HCM management. In the context of HCM management, the latest guidelines from the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines, published in 2024 1, emphasize the importance of shared decision-making, referral to multidisciplinary HCM centers, and careful assessment of family history and genetic testing. Key aspects of HCM management include:
- Assessing a patient’s risk for sudden cardiac death and discussing implantable cardioverter-defibrillator placement 1
- Using cardiac myosin inhibitors, such as mavacamten, to treat patients with symptomatic obstructive HCM 1
- Considering invasive septal reduction therapies, like surgical septal myectomy and alcohol septal ablation, for patients with drug-refractory or severe outflow tract obstruction 1
- Providing oral anticoagulation with direct-acting oral anticoagulants or warfarin for patients with HCM and persistent or paroxysmal atrial fibrillation 1
- Encouraging healthy recreational exercise and careful planning for rigorous exercise training 1 These recommendations prioritize morbidity, mortality, and quality of life outcomes for patients with HCM, and the use of evidence-based treatments and interventions, as outlined in the 2024 guidelines, is crucial for optimal patient care.
From the Research
Treatment Options for Hypertrophic Cardiomyopathy (HCM)
- Beta-blockers, such as metoprolol, are commonly used as first-line therapy to manage symptoms in patients with HCM 2, 3, 4.
- Verapamil, a calcium channel blocker, is often used as second-line therapy for patients who do not respond to beta-blockers or have certain contraindications 2, 3, 4.
- Disopyramide is another medication that may be used to treat patients with HCM who have obstruction and do not respond to beta-blockers and/or verapamil 3.
Efficacy of Metoprolol and Verapamil in HCM
- Studies have shown that metoprolol can effectively reduce left ventricular outflow tract (LVOT) gradients and improve quality of life in patients with HCM 4.
- Verapamil has also been shown to improve exercise capacity in patients with HCM, although its effects on LVOT gradients and baseline hemodynamics may be variable 4.
- Both metoprolol and verapamil have been found to be safe and well-tolerated in patients with HCM, although metoprolol may be better tolerated in some patient populations 4.
Current Management Options for HCM
- In addition to pharmacotherapy, current management options for HCM include lifestyle modifications, familial screening with genetic counseling, sudden cardiac death risk stratification, septal reduction therapy, and heart transplantation 5, 6.
- New medical therapies, such as myosin inhibitors, are being studied and may offer promising treatment options for patients with HCM in the future 6.