Could it be Non-Genetic HCM?

When a patient is the only person in the family ever diagnosed with HCM, s/he will often wonder whether their disease is, in fact, genetic.  S/he will also wonder whether it will be necessary for all first degree relatives to undergo serial screenings for the rest of their lives.

In answer to this concern, Australian researchers have recently identified a subset of HCM patients who appear to have a non-familial form of the disease and whose relatives may be candidates for less stringent screening protocols.

The study, just published in Circulation: Cardiovascular Genetics by Dr. Jodie Ingles and Dr. Chris Semsarian, found that this group, having neither genetic mutation associated with HCM nor family history of HCM, comprises approximately 40% of all HCM patients. Non-familial HCM patients are more likely to be older when diagnosed, and they often present with non-asymmetric hypertrophy and hypertension.  And, these HCM patients appear to have a more favorable clinical course, with a better track record of survival from major cardiovascular events.

The researchers point out that by sorting patients into more distinct subgroups, doctors will be able to provide more personalized and evidence-based care to patients and their families.  In particular, their recommendation is that first-degree relatives of non-familial HCM patients need only be screened one or more times in adulthood.  Less frequent follow up surveillance is also suggested, in contrast with the more intensive screening guidelines recommended for family members of patients with familial HCM.

 

 

 

RESET-HCM: Rethinking Exercise for HCM Patients – Interview with Dr. Sara Saberi and Dr. Sharlene Day

Editor’s note: This is our first interview feature on HCMBeat.  In the future, we hope to feature more interviews with other HCM researchers who have published articles of interest to the HCM community.  

By now, you have probably already heard the buzz about RESET- HCM – a study about the effects of exercise on HCM patients conducted by Dr. Sara Saberi and Dr. Sharlene Day at the Hypertrophic Cardiomyopathy Clinic of the University of Michigan’s Frankel Cardiovascular Center in collaboration with Dr. Matthew Wheeler and Dr. Euan Ashley of Stanford’s HCM Center. The findings were presented at the American College of Cardiology Conference on March 17, 2017 held in Washington D.C. and were the subject of this feature on HCMBeat. 

Recently, Cynthia Waldman of HCMBeat had the opportunity to sit down with Drs. Saberi and Day for a detailed conversation (over Skype) about the study.  What follows is a transcript of their conversation (which has been edited for readability).

Continue reading “RESET-HCM: Rethinking Exercise for HCM Patients – Interview with Dr. Sara Saberi and Dr. Sharlene Day”

Exercise Helps HCM Patients – Results from RESET-HCM Study

Results from a recent study conducted at the University of Michigan and Stanford show that patients who participated in a moderate-intensity cardiovascular exercise program showed a small, but statistically significant increase (6%) in exercise capacity over those who did not participate in the program.  Of note, no adverse events were reported in any of the 136 adults who participated in the RESET-HCM study over its four-month duration. These results were announced over the weekend at the American College of Cardiology meeting in Washington, D.C.

A companion editorial noted that this study is important for establishing the positive impact of exercise on HCM patients. Now, the need is for future research to establish safe exercise guidelines for HCM patients.  Many remain reluctant to exercise due to fear of suffering an adverse event during exercise.

Here is a video interview with one of the authors of the study, Dr. Sara Saberi, discussing the findings at ACC.

Stay tuned to HCMBeat for more about this important work which will hopefully lead to improved quality of life for HCM patients.

Apical Aneurysm is Risk Factor for HCM Patients

A recent retrospective study of patients at Minneapolis Heart Institute and Tufts Medical Center published in the Journal of the American College of Cardiology found that HCM patients who also had left ventricular apical aneurysms were at increased risk of sudden cardiac death and stroke.  However, with increased surveillance and appropriate treatment, including the implantation of a implantable defibrillator, radiofrequency ablation and/or anti-coagulation, as appropriate, the authors suggest that the increased risk can be neutralized.

A summary of this article can be found here.

Irish Researchers Investigate Drug for HCM

EpiCor Therapeutics, a Irish biotech start-up, is investigating whether 5-azacytidine, a drug previously used to treat bone marrow disorders, may reverse the hypertrophy of HCM.  According to the researchers, the drug targets the mechanisms that drive the abnormal thickening of the heart muscle by inhibiting DNA methylation, thereby reducing the growth of cardiac cells.

EpiCor’s work with 5-azacytidine was declared the overall winner of the 2016 Venture Launch Accelerator Programme at Ireland’s University College Dublin where it won the 2016 Start-Up of the Year Award.

So far, EpiCor has gotten approximately €550,000 ($690,000 U.S.) in capitalization from Enterprise Ireland’s Commercialization Fund. The next step for the drug would be to obtain regulatory approval and then, clinical trials.

One Size Does NOT Fit All: Treatments Differ by Stage in HCM

There are distinct stages of HCM and treatments will vary according to the stage. Therefore, it is important, according to a recent article in the Netherlands Heart Journal, for patients to seek treatment from teams experienced in the the treatment of HCM.  These professionals are able to recognize transitions in the course of the disease as they occur, and then implement necessary changes in treatment.

In this thorough overview of HCM and its treatment, Dr. Iacopo Olivotto and his colleagues in the Netherlands observe that HCM is seen infrequently by community cardiologists (as compared to more common heart conditions like coronary artery disease). Hence, one of the major difficulties in HCM practice has been identification of patients at highest risk.

Continue reading “One Size Does NOT Fit All: Treatments Differ by Stage in HCM”

MyoKardia HCM Drug Has Success in Cats

MyoKardia’s experimental drug MYK-461, currently in Stage 2 trials for humans, has now been shown to eliminate left ventricular obstruction in five cats with HCM. It has already been shown to inhibit traits of HCM in mice.

Addressing these findings, Associate Professor Joshua Stern, chief of the Cardiology Service at the University of California, Davis, veterinary hospital, stated:

“There has been little to no progress in advancing the treatment of HCM in humans or animals for many years,” Stern said. “This study brings new hope for cats and people.

Based on these positive results, U.C.Davis is hoping to conduct a clinical trial of MYK-461 to determine whether it could become the standard of care for cats with HCM.

The full text of the article published in Plos One can be found here.

End of the Road for Eleclazine and Liberty HCM Study

 Eleclazine:  The Liberty HCM Trial

It appears to be the end of the road for the Gilead drug eleclazine, a late sodium channel inhibitor previously known as GS-6615.  Eleclazine, with properties similar to the anti-angina drug ranolazine (which was approved by the FDA in 2006), was the subject of a recently terminated HCM clinical trial known as Liberty-HCM.  The HCM eleclazine study focused on whether the drug would improve symptoms and exercise capacity in patients with HCM by increasing their peak oxygen uptake, resulting in improved VO2 max readings on exercise testing.  The HCM study began enrolling patients in February 2015. Data collection had been scheduled to continue through June 2017. Continue reading “End of the Road for Eleclazine and Liberty HCM Study”

Depression: 10 Ways for Heart Patients to Cope Without Using Medication

This highly informative blog article from Carolyn Thomas of Heart Sisters , while targeted toward people with coronary artery disease, contains much useful information which can be applied to heart patients with other conditions as well.  This particular article offers many useful suggestions of ways to help combat depression which could just as easily be implemented by those with HCM.

An added bonus is that most of these suggestions do not involve ingesting anything at all!

One caveat she mentions, which bears repeating, is that you should ALWAYS discuss any type of dietary supplement with your cardiologist before you begin taking it.

Computer Algorithms Used to Diagnose HCM

A study published yesterday in the Journal of the American College of Cardiology demonstrated the usefulness of computer algorithms in distinguishing hearts with HCM from athlete’s hearts on echocardiogram.  The computer algorithms were able to automatically classify the echocardiographic images by distinguishing between changes seen in hypertrophic cardiomyopathy  and changes seen in athletes’ hearts due to athletic conditioning.

Dr. Partho P. Sengupta, who authored the study, said that this technology may prove to be a useful tool in recognizing and diagnosing HCM for those who lack the experience to distinguish these conditions on echocardiogram.