MD Conference Express ACC 2012 - (Page 37)
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The New Hypertrophic Cardiomyopathy Practice Guidelines
Written by Maria Vinall
New practice guidelines for hypertrophic cardiomyopathy (HCM) were issued in 2011 by the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) [Gersh BJ et al. Circulation 2011]. Michael J Ackerman, MD, Mayo Clinic, Rochester, Minnesota, USA, discussed the new guidelines for genetic testing for HCM from both the ACCF/AHA and from the Heart Rhythm Society/European Heart Rhythm Association (HRS/EHRA) [Ackerman MJ et al. Heart Rhythm 2011. Under the ACCF/AHA guidelines genetic testing: • • is recommended in patients with atypical clinical presentation of HCM or when another genetic condition is suspected (Class I; Level of Evidence [LoE] B) is reasonable in the index patient to facilitate identification of first-degree family members who are at risk for developing HCM (Class IIa; LoE B) comprehensive or targeted HCM genetic testing is recommended for any patient in whom a cardiologist has established a clinical diagnosis of HCM based on examination of the patient’s clinical history, family history, and electro-/echocardiographic phenotype mutation-specific genetic testing is recommended for family members and appropriate relatives following the identification of the HCM-causative mutation in an index case
Using the HRS/EHRA guidelines (both Class I; LoE C [ie Expert Consensus]): •
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Milind Y. Desai, MD, Cleveland Clinic, Cleveland, Ohio, USA, presented a summary of the recommendations for the use of echocardiography. Some of the specific recommendations concerned the use of transthoracic echo as part of: • • • the initial evaluation of all patients with suspected HCM (Class I; LoE B) the screening algorithm for family members (Class I; LoE B) periodic screening for children of HCM patients (Class I; LoE C) Official Highlights From the
Martin S. Maron, MD, Tufts Medical Center, Boston, Massachusetts, USA, presented the recommendations for the use of cardiac MRI (CMR). The new guidelines indicate the use of CMR imaging: • in patients with suspected HCM to detect segmental areas of increased left ventricular wall thickening that are not seen by echocardiography (eg, anterolateral wall, apex and posterior septum; Class I; LoE B) in patients with HCM when this additional information might have an impact on risk assessment and treatment decisions regarding appropriate selection of invasive septal reduction therapy (Class I; LoE B) for identification of high-risk patients using late gadolinium enhancement in selected HCM patients in whom risk stratification remains uncertain after assessment with conventional sudden death markers (Class IIb; LoE C)
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ACC-i2
with
innovation in intervention
March 24 – 27, 2012 • CHICAGO
Exhibits: March 24 – 26
Highlights from the American College of Cardiology 61st Annual Scientific Session
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Table of Contents for the Digital Edition of MD Conference Express ACC 2012
MD Conference Express ACC 2012
Table of Contents
Treatment of AMI in the Post-Herrick Era
The State of Hypertension Guidelines: 2012
ACRIN PA 4005: Coronary CTA in the ED Identifies Low-Risk Patients and Shortens Length of Stay
One-Year STAMPEDE Trial Results
TAVR Associated with Increased Late Mortality from Paravalvular Regurgitation
The CABG Surgery Off- or On- Pump- Revascularization Study (CORONARY)
The Moderate PE Treated with Thrombolysis Study (MOPETT)
Pacemaker Therapy In Patients With Neurally Mediated Syncope and Documented Asystole
Outcomes from the BRIDGE-ACS Trial
ROMICAT II: More Data Evaluating CT-First for Acute Chest Pain ED Triage
Elective PCI at Community Hospitals With Versus Without On-Site Surgery
Results from the TRA 2P-TIMI 50 Trial
The HOST-ASSURE Randomized Trial
New Monoclonal Antibody to PCSK9 Markedly Lowers LDL-C in Patients on Atorvastatin
Oral Rivaroxaban Alone for Symptomatic PE
Neutral Outcomes But Important Insights From FOCUS-CCTRN
Imaging
STEMI
Acute Coronary Syndrome
Antiplatelet Therapy
New Anti-Diabetes Agents Offer Promise in the Fight Against CVD
The New Hypertrophic Cardiomyopathy Practice Guidelines
MD Conference Express ACC 2012
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