Exercise Testing Important for HCM Patients

According to a recent study by doctors at Tufts HCM Center in collaboration with colleagues in Italy, exercise testing is an invaluable tool in the assessment of hypertrophic cardiomyopathy patients.

In particular, two types of exercise testing are most valuable for HCM patients:

  • Exercise Echocardiogram:  These tests are valuable in determining whether a patient has obstruction.  It provides a physiological way to measure whether or not a patient has an obstructed left ventricular outflow tract and hence, may potentially be in need of an invasive procedure to treat the obstruction.  According to the article, approximately 1/3 of HCM patients have latent obstruction which may only be seen during or after exercise.  This obstruction is not always apparent from their resting echocardiogram.

and

  • Cardiopulmonary Exercise Testing:  These tests help determine functional capacity and provide a quantifiable indicator of heart failure symptoms.  This test  can identify patients in need of more aggressive treatment options, or who are potentially in need of transplant.  A particularly valuable piece of data from this test is the “VO2 max” score, which is a measure of the maximum rate of oxygen consumption during exercise which reflects the cardiorespiratory fitness level of a person.

*Editor’s note – Exercise testing was particularly informative and important in my own HCM treatment.  It was only after my doctors performed an exercise echo that the extent of my obstruction became apparent.  The symptoms I had been suffering appeared to be out of proportion to what was visualized on my resting echo.  The exercise echo helped my doctors understand the cause of my symptoms which made the next step, in my case a myectomy, much clearer.

You can read my full story here .

 

 

Risk of Cardiac Arrest Low During Sex

According to research presented this week at the American Heart Association’s Scientific Sessions, the risk of dying from sudden cardiac arrest during or within 1 hour of sex is less than 1%.

The study, published by Dr. Sumeet Chugh of Cedars-Sinai Hospital in Los Angeles, looked at data collected in the Oregon Sudden Unexpected Death Study (Oregon SUDS) database between 2002 and 2015.

Dr. Chugh emphasized that survival was higher in the group of patients who received CPR, re-emphasizing the importance of teaching CPR in the general population.

For more details on this study, see these stories:

Newsweek

NBC News

Minn Post

 

 

HIGHLIGHTS FROM THE INTERNATIONAL HCM SUMMIT VI, PART II

**Because so much HCM information was presented at the Summit, this is the second of multiple blog entries.  Stay tuned to HCMBeat for more highlights from the HCM Summit.  To see Part I of this series of highlights from the HCM Summit VI, click here.**

The 6th International HCM Summit was held October 27, 28 and 29th in Boston, Massachusetts.  This symposium brings together HCM professionals from around the world who are there to learn about and discuss the latest developments in the treatment of HCM.

The symposium was organized by long time HCM expert Dr. Barry Maron and his son, Dr. Martin Maron.  Both Marons are now affiliated with Tufts Medical Center’s Hypertrophic Cardiomyopathy Center.

What follows are summaries from selected talks presented at the meeting.  The presenter and their hospital affiliation are noted below, along with the topic of their presentation.  When possible, you may access the presenters’ slides via hyperlink by clicking on the name. (Note that not all presenters made their slides available).

Continue reading “HIGHLIGHTS FROM THE INTERNATIONAL HCM SUMMIT VI, PART II”

HIGHLIGHTS FROM THE INTERNATIONAL HCM SUMMIT VI, PART I

**Because so much HCM information was presented at the Summit, this will be the first of multiple blog entries.  Stay tuned to HCMBeat for more highlights from the HCM Summit.  You will find Part II of this series by clicking here.**

The 6th International HCM Summit was held October 27, 28 and 29th in Boston, Massachusetts.  This symposium brings together HCM professionals from around the world who are there to learn about and discuss the latest developments in the treatment of HCM.

The symposium was organized by long time HCM expert Dr. Barry Maron and his son, Dr. Martin Maron.  Both Marons are now affiliated with Tufts Medical Center’s Hypertrophic Cardiomyopathy Center.

What follows are summaries from selected talks presented at the meeting.  The presenter and their hospital affiliation are noted below, along with the topic of their presentation.  When possible, you may access the presenters’ slides via hyperlink by clicking on the name. (Note that not all presenters made their slides available).

Continue reading “HIGHLIGHTS FROM THE INTERNATIONAL HCM SUMMIT VI, PART I”

Greater Certainty in Genetic Testing Results at HCM Specialty Centers

A recent study published by members of the SHaRe Cardiomyopathy Registry found that genetic test results for HCM are more definitive and helpful to patients when testing has been carried out at a high volume HCM center – especially a center that shares genetic data with other HCM centers. 

Continue reading “Greater Certainty in Genetic Testing Results at HCM Specialty Centers”

Echo Measurement May Help to Guide HOCM Treatment Plan

Doctors at the Cleveland Clinic recently published a study in the Journal of the American Heart Association suggesting that the measurement of left ventricular global longitudinal strain (LV-GLS), as determined by routine echocardiogram, may be helpful in determining treatment strategy for patients with obstructive HCM. 

In particular, the researchers found that a poor LV-GLS measurement seemed to correlate with a higher incidence of sudden cardiac arrest and appropriate ICD discharge.  Worsening LV‐GLS of less than -14% was associated with poorer prognosis, while myectomy seemed to improve LV‐GLS.

The researchers also found that a small number of HCM patients (including post-myectomy patients) with severely reduced LV‐GLS (worse than ≈ −7%) appeared to be in need of aggressive treatment, potentially including heart transplantation.

Chapter 3: MRI Safety for ICD & Pacemaker Patients

Long awaited results of the MagnaSafe study regarding the safety of MRIs in patients with implantable devices were published in February.   The MagnaSafe study established a multi-center prospective registry for patients undergoing MRI scans despite their having an implanted device not deemed safe for MRI scanning by the FDA.

Continue reading “Chapter 3: MRI Safety for ICD & Pacemaker Patients”

Atrial Fibrillation: Treatable HCM Complication

A recent paper by doctors at Tufts University’s HCM Center found that transient episodes of atrial fibrillation (AF) are treatable and do not often progress to permanent AF.

This study found that AF was not a frequent cause of death by heart failure or sudden cardiac arrest.  However, the researchers identified AF as an important cause of stroke in HCM patients.  Therefore, they recommend a low threshold for starting HCM patients on anti-coagulants following an initial AF episode.

Researchers in this study analyzed statistics from 1558 HCM patients, 20% of whom experienced AF.  74% experienced only sporadic episodes, while 26% went on to develop permanent AF.

At the time of publication, 91% of the 277 of the patients included in the sample were still alive and between the ages 49 and 75 years old.

According to an accompanying editorial by Italian HCM expert Dr. Paolo Spirito, the outlook for HCM patients with atrial fibrillation has improved over the last twenty years due to significant advances in HCM treatment over that time period such as ICD implantation and myectomy, along with aggressive anti-coagulation for atrial fibrillation patients.

Spirito also noted that it is difficult to predict whether a given HCM patient will go on to develop permanent Afib after a single episode since many will not.  Additionally, permanent afib can be well tolerated when there is contemporaneous control of heart rate.  Therefore,  anti-arrhythmic medications, which can cause unpleasant side effects, may not be necessary for HCM patients with afib as long as anti-coagulation measures are taken.

 

 

 

More is Needed for Women With HCM

A recent study published in the European Heart Journal by doctors from the Mayo Clinic showed that women with hypertrophic cardiomyopathy (HCM) have a statistically reduced rate of survival as compared to men with HCM.

Continue reading “More is Needed for Women With HCM”

A Risk Calculator for Sudden Death -Results of HCM-EVIDENCE Study

The HCM Risk–SCD Score

In 2014, the European Society of Cardiology (ESC) introduced a numerical predictor (the “HCM Risk–SCD score”) to assist physicians in identifying those patients at highest risk for sudden cardiac death who would benefit from the implantation of a prophylactic implantable cardioverter-defibrillator.

Using an algorithm generated by the answers to a series of questions, the tool estimates the 5-year risk of sudden cardiac arrest for any particular patient.  You can find the tool online here.

Continue reading “A Risk Calculator for Sudden Death -Results of HCM-EVIDENCE Study”