What question did this study set out to answer?

To establish a comprehensive framework for the evaluation and management of hypertrophic cardiomyopathy (HCM).

March 15, 2026European Journal of Heart Failure0 citations

Comprehensive evaluation of hypertrophic cardiomyopathy: European Journal of Heart Failure expert consensus document

PMP MartensZiekenhuis Oost-Limburg IOIacopo OlivottoMeyer Children's Hospital PGP Garcia-PaviaHospital Universitario Puerta de Hierro Majadahonda

Key Result

A structured six-pillar framework is essential for the comprehensive evaluation and management of hypertrophic cardiomyopathy, enhancing diagnosis and care outcomes.

Key Points

To establish a comprehensive framework for the evaluation and management of hypertrophic cardiomyopathy (HCM).
Structured approach outlines six key domains for HCM care.
Differentiation between sarcomeric HCM and phenocopies using imaging and genetic testing.
Risk stratification integrates risk scores and imaging data for SCD prevention.
Assessment of left ventricular outflow tract obstruction guides symptom management.
Focus on patient education and comorbidity management for holistic care.
Proposed framework organizes HCM evaluation into six critical domains.
Enhanced understanding of symptom management and treatment options.
Improved risk assessment strategy for sudden cardiac death.
Standardization of genetic evaluation and family management practices.

Structured PICO

Population

Patients with hypertrophic cardiomyopathy (HCM)

Intervention

A six-pillar framework for the evaluation and management of HCM

This expert consensus document provides a structured, multidisciplinary six-pillar framework to standardize and optimize the evaluation and management of hypertrophic cardiomyopathy.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease and a leading cause of heart failure and sudden cardiac death (SCD) in young adults. Given its complex pathophysiology, phenotypic diversity, and rapidly evolving therapeutic landscape, a structured and multidisciplinary approach to care is essential. This manuscript outlines a six-pillar framework to standardize and optimize evaluation and management of HCM. The proposed model organizes HCM care into six key domains. (i) Establishing the correct diagnosis, which requires differentiation between sarcomeric HCM and phenocopies such as amyloidosis, Fabry, or mitochondrial disease, using multimodal imaging and genetic testing. (ii) Establish presence of symptoms and of left ventricular outflow tract obstruction (LVOTO), which is central to symptom evaluation, prognostication, and treatment. Dynamic assessment with exercise echocardiography when required is essential to guide management, including pharmacotherapy or septal reduction therapy. (iii) Risk stratification for SCD integrates risk scores with adjunctive imaging data to support patient-centred implantable cardioverter defibrillator decisions. (iv) Genetic evaluation and family management enable cascade testing, early detection, and counselling. (v) Management of comorbidities-including atrial fibrillation, hypertension, obesity, and sleep-disordered breathing-is integral to holistic care and symptom control. (vi) Education and lifestyle guidance focus on safe sport participation, avoidance of dehydration and vasodilators, and reproductive counselling within a multidisciplinary setting.

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