Zusammenfassung
Die ESC Leitlinie 2014 zur hypertrophischen Kardiomyopathie (HCM) fasst mit 133 ausformulierten und abgestimmten Empfehlungen, für die 506 Literaturstellen hinterlegt sind, den aktuellen Erkenntnisstand zu Diagnostik, Management und Therapie des Phänotyps HCM zusammen. Neu im Vergleich zur letzten, 10 Jahre alten ACC/ESC-Leitlinie sind die Einarbeitung aktueller Erkenntnisse zur Genetik, konkrete Empfehlungen zum genetischen Screening von betroffenen Familien, die Betonung klinischer Leitsymptome (Signale) zur Zuordnung zu selteneren nichtobstruktiven HCM-Varianten, die Betonung der nicht-invasiven Bildgebung mit Echokardiographie und Kardio-MRT sowie eine Formel zur Abschätzung des Risikos für einen plötzlichen Herztod. Dabei sollte nicht vergessen werden, dass die meisten Patienten mit einer HCM ein weitgehend normales Leben führen. Der hohe Detaillierungsgrad der Leitlinie erweist sich sowohl für den Kardiomyopathieexperten als auch für den Internisten und Allgemeinmediziner als eine ausgezeichnete, strukturierte Zusammenfassung des gegenwärtigen Wissenstands.
Abstract
The 2014 European Society of Cardiology (ESC) guidelines on the diagnosis and management of hypertrophic cardiomyopathy (HCM) comprise 133 recommendations with 506 references. In comparison to the last 10-year-old American College of Cardiology Foundation (ACCF)/ESC guidelines new data have been added, such as recent studies on genetics, updated recommendations for family and genetic screening, a special emphasis on red flags in clinical symptomatology and diagnostic features for the identification of non-obstructive variants of HCM, on multimodality non-invasive imaging by echocardiography and cardiac magnetic resonance imaging (MRI) and a HCM risk formula for the assessment of sudden cardiac death within 5 years. Nevertheless, it should not be forgotten that the majority of patients with HCM lead a normal life. This detailed update and the structured recommendations are an excellent summary of the current knowledge on HCM for the cardiomyopathy specialist and also for internists and general physicians.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Elliott PM, Anastasakis A, Borger MA et al (2014) 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy. The Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35(39):2733–2779
Elliott P, Andersson B, Arbustini E et al (2008) Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 29:270–276
Maisch B, Noutsias M, Ruppert V et al (2012) Cardiomyopathies: classification, diagnosis, and treatment. Heart Failure Clin 8:53–78
Richardson P, McKenna W, Bristow M et al (1996) Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 93(5):841–842
Maron BJ, McKenna WJ, Danielson GK et al (2003) 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. J Am Coll Cardiol 42:1687–1713
Maron BJ, Pelliccia A, Spirito P (1995) Cardiac disease in young trained athletes. Insights into methods for distinguishing athlete’s heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy. Circulation 91:1596–1601
Pelliccia A, Maron BJ, Spataro A et al (1991) The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med 324:295–301
Gersh BJ, Maron BJ, Bonow RO et al (2011) 2011 CCF/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. Circulation 124:e783–e831
Hengstenberg C, Carrier L, Schwartz K, Maisch B (1994) Clinical and genetic heterogeneity of familial hypertrophic cardiomyopathy. Herz 19(2):84–90
Rapezzi C, Arbustini E, Caforio AL et al (2013) Diagnostic work-up in cardiomyopathies: bridging the gap between clinical phenotypes and final diagnosis. A position statement from the ESC Working Group on Myocardial and Pericardial Diseases. Eur Heart J 34:1448–1458
Wicks EC, Elliot PM (2012) Genetics and metabolic cardiomyopathies. Herz 37:598–611
Kloos W, Katus HA, Meder B (2012) Genetic cardiomypathies. Lessons learned from humans, mice, and zebrafish. Herz 37:612–618
McLeod CJ, Ackerman MJ, Nishimura RA et al (2009) Outcome of patients with hypertrophic cardiomyopathy and a normal electrocardiogram. J Am Coll Cardiol 54:229–233
Kuhn H, Gietzen FH (1999) Hypertrophische Kardiomyopathien. In: Daniel W (Hrsg) Kardiologie. Thiemes Innere Medizin (TIM). Thieme, Stuttgart New York, S 1211–1218
Leone O, Veinot JP, Angelini A et al (2012) 2011 consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology. Cardiovasc Pathol 21:245–274
Cooper LT, Baughman KL, Feldman AM et al (2007) The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology. Eur Heart J 28:3076–3093
Maisch B, Pankuweit S (2012) Current treatment options in (peri)myocarditis and inflammatory cardiomyopathy. Herz 6:644–656
Yilmaz A, Kindermann I, Kindermann M et al (2010) Comparative evaluation of left and right ventricular endomyocardial biopsy: differences in complication rate and diagnostic performance. Circulation 122(9):900–909
Mahrholdt H, Wagner A, Judd RM et al (2005) Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 26:1461–1474
Vogelsberg H, Mahrholdt H, Deluigi CC et al (2008) Cardiovascular magnetic resonance in clinically suspected cardiac amyloidosis: noninvasive imaging compared to endomyocardial biopsy. J Am Coll Cardiol 51:1022–1030
Green JJ, Berger JS, Kramer CM, Salerno M (2012) Prognostic value of late gadolinium enhancement in clinical outcomes for hypertrophic cardiomyopathy. JACC Cardiovasc Imaging 5:370–377
Elliott PM, Gimeno JR, Thaman R et al (2006) Historical trends in reported survival rates in patients with hypertrophic cardiomyopathy. Heart 92:785–791
Maisch B, Rupp H (2006) Myocardial fibrosis: a cardiopathophysiologic Janus head. Herz 31(3):260–268
O’Mahony C, Jichi F, Pavlou M et al (2013) A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM Risk-SCD). Eur Heart J 35(30):2010–2020
Pelliccia A, Fagard R, Bjornstad HH et al (2005) Recommendations for competitive sports participation in athletes with cardiovascular disease: a consensus document from the Study Group of Sports Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 26:1422–1445
Einhaltung ethischer Richtlinien
Interessenkonflikt. B. Maisch und H. Mahrholdt erklären, dass kein Interessenkonflikt besteht.
Dieser Beitrag enthält keine Studien an Menschen oder Tieren.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Maisch, B., Mahrholdt, H. ESC-Leitlinie 2014 zur Diagnose und zum Management der hypertrophischen Kardiomyopathie. Herz 39, 919–930 (2014). https://doi.org/10.1007/s00059-014-4177-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00059-014-4177-z