ABC Imagem Cardiovasc. 2026; 39(1): e20260027
Hypertrophic Cardiomyopathy: Standardization of Echocardiographic Assessment in an Era of New Therapies
DOI: 10.36660/abcimg.20260027i
Hypertrophic cardiomyopathy (HCM) has become the most common inherited myocardial disease, with an estimated global prevalence between 1:200 and 1:500. Despite its relatively high frequency in the general population, the disease remains significantly underdiagnosed. Only about 15% of affected individuals are clinically identified, due mainly to the wide variability of phenotypes and clinical manifestations., Slightly more than half of patients may develop progressive symptoms or experience adverse events throughout their lifetime. Early identification, risk stratification, and cardiovascular therapies and interventions have reduced mortality rates to < 1.0% per year.
The pathophysiology of HCM is based on myocardial hypertrophy in the absence of secondary causes, associated with hypercontractility and diastolic dysfunction, resulting from abnormal myosin activation. Approximately 75% of patients present with left ventricular outflow tract (LVOT) obstruction at rest or after provocative maneuvers. In the absence of an obstructive pattern, the disease course is usually favorable, oligosymptomatic, or asymptomatic, with a minority progressing to advanced stages.–
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