It is important that the medical profession plays a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced and tested in the detection, management, or prevention of disease states. Rigorous and expert analysis of the available data documenting absolute and relative benefits and risks of those procedures and therapies can produce helpful guidelines that improve the effectiveness of care, optimize patient outcomes, and favorably affect the overall cost of care by focusing resources on the most effective strategies.

The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have jointly engaged in the production of such guidelines in the area of cardiovascular disease since 1980. The ACC/AHA Task Force on Practice Guidelines, whose charge is to develop, update, or revise practice guidelines for important cardiovascular diseases and procedures, directs this effort. The Task Force is pleased to have this guideline developed in conjunction with the European Society of Cardiology (ESC). Writing committees are charged with the task of performing an assessment of the evidence and acting as an independent group of authors to develop or update written recommendations for clinical practice.

Experts in the subject under consideration have been selected from all 3 organizations to examine subject-specific data and write guidelines. The process includes additional representatives from other medical practitioner and specialty groups when appropriate. Writing committees are specifically charged to perform a formal literature review, weigh the strength of evidence for or against a particular treatment or procedure, and include estimates of expected health outcomes where data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that might influence the choice of particular tests or therapies are considered as well as frequency of follow-up and cost effectiveness. When available, information from studies on cost will be considered; however, review …

/pdf/acc-aha-esc-2006-guidelines-for-management-of-patients-with-5a3f1emfzy.pdf

ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

ContextThroughout the past 40 years, a vast and sometimes contradictory literature
has accumulated regarding hypertrophic cardiomyopathy (HCM), a genetic cardiac
disease caused by a variety of mutations in genes encoding sarcomeric proteins
and characterized by a broad and expanding clinical spectrum.ObjectivesTo clarify and summarize the relevant clinical issues and to profile
rapidly evolving concepts regarding HCM.Data SourcesSystematic analysis of the relevant HCM literature, accessed through
MEDLINE (1966-2000), bibliographies, and interactions with investigators.Study Selection and Data ExtractionDiverse information was assimilated into a rigorous and objective contemporary
description of HCM, affording greatest weight to prospective, controlled,
and evidence-based studies.Data SynthesisHypertrophic cardiomyopathy is a relatively common genetic cardiac disease
(1:500 in the general population) that is heterogeneous with respect to disease-causing
mutations, presentation, prognosis, and treatment strategies. Visibility attached
to HCM relates largely to its recognition as the most common cause of sudden
death in the young (including competitive athletes). Clinical diagnosis is
by 2-dimensional echocardiographic identification of otherwise unexplained
left ventricular wall thickening in the presence of a nondilated cavity. Overall,
HCM confers an annual mortality rate of about 1% and in most patients is compatible
with little or no disability and normal life expectancy. Subsets with higher
mortality or morbidity are linked to the complications of sudden death, progressive
heart failure, and atrial fibrillation with embolic stroke. Treatment strategies
depend on appropriate patient selection, including drug treatment for exertional
dyspnea (β-blockers, verapamil, disopyramide) and the septal myotomy-myectomy
operation, which is the standard of care for severe refractory symptoms associated
with marked outflow obstruction; alcohol septal ablation and pacing are alternatives
to surgery for selected patients. High-risk patients may be treated effectively
for sudden death prevention with the implantable cardioverter-defibrillator.ConclusionsSubstantial understanding has evolved regarding the epidemiology and
clinical course of HCM, as well as novel treatment strategies that may alter
its natural history. An appreciation that HCM, although an important cause
of death and disability at all ages, does not invariably convey ominous prognosis
and is compatible with normal longevity should dictate a large measure of
reassurance for many patients.

https://jamanetwork.com/journals/jama/articlepdf/194713/jcc10012.pdf

Hypertrophic cardiomyopathy: A Systematic review

Writing committee me tions to which their s ply; see Appendix ACCF/AHATask Fo Surgeons Representa tative Heart Rhythm ography and Int Echocardiography Re ciety of America Rep resentative kkACCF/ Task Force member d This document was app Board of Trustees and ordinating Committee gery, American Soc Cardiology, Heart Fa for Cardiovascular A geons approved the d The American Associat as follows: Gersh BJ Naidu SS, Nishimura Bernard J Gersh, MB, ChB, DPhil, FACC, FAHA, Co-Chair* Barry J Maron, MD, FACC, CoChair* Robert O Bonow, MD, MACC, FAHA, Joseph A Dearani, MD, FACC,§,k Michael A Fifer, MD, FACC, FAHA,* Mark S Link, MD, FACC, FHRS,* Srihari S Naidu, MD, FACC, FSCAI,* Rick A Nishimura, MD, FACC, FAHA, Steve R Ommen, MD, FACC, FAHA, Harry Rakowski, MD, FACC, FASE,** Christine E Seidman, MD, FAHA, Jeffrey A Towbin, MD, FACC, FAHA, James E Udelson, MD, FACC, FASNC, and Clyde W Yancy, MD, FACC, FAHAkk

/pdf/2011-accf-aha-guideline-for-the-diagnosis-and-treatment-of-4tvvqpnd44.pdf

2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

https://www.urgences-serveur.fr/IMG/pdf/TDRV_ESC.pdf

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)

American College of Cardiology/European Society of Cardiology Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines

Background Hypertrophic cardiomyopathy is a disease entity characterized by marked heterogeneity in morphology and natural history. Most of our knowledge of the natural history of this disorder derives from the study of hospital-based populations and is influenced by referral bias. Therefore, this population-based study was undertaken to examine the natural history of hypertrophic cardiomyopathy among unselected residents of Olmsted County, Minnesota. Methods and Results Patients with hypertrophic cardiomyopathy, confirmed by echocardiography, were identified by use of the resources of the Rochester Epidemiology Project. Patients with the echocardiographic features of hypertrophic cardiomyopathy but with long-standing hypertension requiring drug therapy were categorized as having hypertensive hypertrophic cardiomyopathy. Baseline clinical details and follow-up events were obtained by retrospective chart review. Thirty-seven patients were diagnosed with hypertrophic cardiomyopathy and 24 with hypertensive ...

Guy S. Reeder

Papers

Natural history of hypertrophic cardiomyopathy. A population-based study, 1976 through 1990.