Patients Fare Best at HCM Specialty Centers

A recent retrospective study conducted by doctors at Yale -New Haven Health System found that patients with hypertrophic cardiomyopathy fare best when treated at a specialty center using a team approach to HCM. The study found that this was especially true for patients coming from disadvantaged backgrounds who often fare worse outside of a HCM specialty setting.

The findings of this study suggest that patients with HCM are best served when referred to HCM specialty care instead of receiving care solely from general cardiologists.

The Future of HCM Care

Dr. Stephen Heitner, together with his colleagues at Oregon Health & Sciences University, published an article last week in the European Journal of Heart Failure which gives a glimpse into the treatment of hypertrophic cardiomyopathy (HCM) in the future.  Although recent publications have stated that the majority of HCM patients today have a favorable prognosis when receiving appropriate treatment, a heavy disease burden continues to be placed upon patients.  Hence, better and more effective treatments for HCM are still needed in order to lessen this burden.

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Atrial Fibrillation? Try Giving Up Alcohol

A recent study published in the New England Journal of Medicine found that drinkers suffering from atrial fibrillation who stopped drinking for the period of the study significantly reduced episodes of atrial fibrillation. 

According to doctors, alcohol consumption appears to be a significant risk factor and trigger for atrial fibrillation, while teetotaling appears to have a profound impact.

Dr. John Osborne, an American Heart Association spokesperson, said the benefit from giving up drinking was similar to results seen from drugs used to treat atrial fibrillation.  Even if patients are not able to completely abstain from alcohol, Osborne advised cutting back significantly. “It costs nothing and led to a substantial reduction in hospital rates. People in the abstinence group also lost an average of 3.8 kilograms [8.4 pounds] in six months,” he said.

Not everyone thinks that teetotaling is a workable treatment for afib, however. Critics say that encouraging abstinence is unrealistic and is not a permanent solution to the problem.  In fact, a planned follow-up study had to be shortened due the difficulty of finding participants willing to abstain from drinking for a whole year.

 

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Cytokinetics Announces its Phase 2 Clinical Trial – “Redwood-HCM”

Cytokinetics today announced that its Phase 2 double-blind study of its experimental drug CK-274 entitled “REDWOOD-HCM” (Randomized Evaluation of Dosing With CK-274 in Obstructive Outflow Disease in HCM (hypertrophic cardiomyopathy) has begun enrollment.  The trial will enroll patients with symptomatic, obstructive HCM.

CK-274 is a next-generation cardiac myosin inhibitor which the company hopes will prove to be beneficial for the treatment of hypertrophic cardiomyopathy (HCM).

There are currently two companies in clinical trials for HCM:  Cytokinetics and MyoKardia. You can read more about their efforts here and here.

 

Racial Differences in HCM

A recent study  found that African-American patients with HCM tend to be younger and more symptomatic than their white counterparts. Additionally, these patients are less likely to undergo septal reduction therapies or have genetic testing.

The implications, according to Dr. Neal Lakdawala of Brigham and Women’s Hospital who is an author of the study, is that doctors should always consider the possibility of hypertrophic cardiomyopathy in patients with left ventricular hypertrophy.  If diagnosed with HCM, these patients should be referred to specialists with experience in treating HCM.  This could potentially help these patients avoid the two most devastating complications of HCM:  sudden death and stroke.

 

More HCM Research is Needed

A recent study in Europe found that HCM patients’ risk of death continues to exceed the risk in the general population.

This study looked at 4893 patients with hypertrophic cardiomyopathy treated at 7 different European HCM centers between 1980 and 2013. Although the statistics improved for those who were treated more recently, this study makes it clear that there is still much room for improvement in risk stratification and treatment for patients with HCM.

MRIs for ICD and Pacemaker Patients

Here is an informative new video from our friend Doug Rachac that nicely explains the safety of MRIs for patients with implantable defibrillators and pacemakers.

I wrote a blog piece about this same issue a few years back. Here it is:

Yes We Scan! ICDs and MRIs

And a few other relevant blog entries here on HCMBeat:

Study Shows MRIs Safe for Pacemaker & ICD Patients

Chapter 3: MRI Safety for ICD & Pacemaker Patients

Safety of MRIs With Abandoned Leads

Last year, Doug wrote this blog entry for HCMBeat specifically about magnets and airports. Read that here:

Blogger Doug Rachac – Magnets and Airports: Should ICD Patients Be Afraid?

And, you can find more about ICDs from Doug on his YouTube Channel.

Overweight HCM Patients Fare Worse

This week, researchers from the eight HCM centers comprising the Sarcomeric Human Cardiomyopathy Registry [SHARE Registry] published a paper that every HCM patient should take to heart.

The sobering findings are that overweight HCM patients have a higher incidence of obstruction, heart failure and atrial fibrillation than their normal weight counterparts. As a result of this study, the researchers suggest heightened attention to weight management and exercise in order to prevent disease-related progression and complications.

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Data From HCM Registry to Inform Personalized HCM Treatment in Future

Several years ago, researchers from the University of Virginia (UVA) and the University of Oxford announced a joint project involving a large international registry of hypertrophic cardiomyopathy (HCM) patients to facilitate research into HCM. Backed with funding from the National Heart Lung and Blood Institute, this project, known as the HCM Registry, includes data from 2,750 patients with HCM at 44 sites in six countries. 

This week, researchers from UVA announced their first findings from this registry which suggest that HCM patients can be separated into two basic groups:

  1.  Patients with a known genetic mutation who are not obstructed but have scarring of the heart muscle;
  2. Patients who do not have a known genetic mutation and do not exhibit scarring, but who do have a significant amount of obstruction to blood flow.

According to Dr. Christopher Kramer of UVA, this information should provide doctors with information that allows them to better assess the degree of risk to any particular patient, and to help inform a treatment strategy for each patient based on his or her unique profile.

Dr. Harry Lever Speaks Out About Problems With Generic Drugs

This Medscape article highlights the extraordinary efforts of Dr. Harry Lever, Director of the Cleveland Clinic’s Hypertrophic Cardiomyopathy Center, in educating patients and physicians alike about quality issues with generic drugs.  Dr. Lever has been instrumental in publicizing the fact that generic drugs are NOT always the same as their name brand counterparts, and that foreign generics are not put through the same level of scrutiny as drugs in the U.S.

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