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© 2023 Hypertrophic Cardiomyopathy Medical Society
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Tune into our bi-monthly podcast where we interview experts in the field to broaden the awareness of new HCM studies & advancements!
32 Episodes
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In this episode of In the Thick of It, Dr. John Fritzson joins leading electrophysiologist Dr. Mark Link and Hannah and Bethany from Heart Charged to discuss the critical role of implantable cardioverter-defibrillators (ICDs) in managing hypertrophic cardiomyopathy. The group navigates the complex clinical landscape of ICD indications, including the importance of MRI findings and specific risk factors like non-sustained ventricular tachycardia (NSVT). Dr. Link provides an expert comparison of transvenous, subcutaneous (S-ICD), and the latest extravascular (EV-ICD) technologies, focusing on device durability and suitability for active patients. Throughout the conversation, the "Bionic Babes" of Heart Charged offer invaluable patient perspectives on life with a defibrillator, the necessity of shared decision-making, and the evolving guidelines that now encourage vigorous exercise for those living with the condition.
In this episode of In the Thick of It, Dr. Floridian Rader and Dr. Ahmad Masri discuss the transformative results of the MAPLE trial, a head-to-head study comparing aficamten—a cardiac myosin inhibitor—to metoprolol in patients with symptomatic obstructive hypertrophic cardiomyopathy1. The trial utilized a rigorous "double-dummy" design to ensure blinding while testing both medications at therapeutic doses2. Dr. Masri highlights unexpected findings, including the significant reduction in peak $VO_2$ and the worsening of cardiac biomarkers like NT-proBNP in the metoprolol group3. The conversation explores how these results challenge decades of reliance on beta-blockers as a first-line therapy and demonstrate the efficacy of aficamten as a potent upfront monotherapy for improving patient function and cardiac remodeling4.
In this episode of In the Thick of It, Dr. Madeline Smoot talks with Dr. Alex McNamara to discuss the complexities of managing refractory symptoms in patients with hypertrophic cardiomyopathy (HCM). The conversation highlights the distinction between obstructive and non-obstructive symptoms, emphasizing the importance of provocative testing—such as cardiopulmonary exercise testing (CPET) and gold-directed Valsalva maneuvers—to unmask "labile" obstruction that resting echoes might miss. They explore the evolving role of cardiac myosin inhibitors and the potential impact of GLP-1 agonists on obesity-related symptom burden. Additionally, Dr. McNamara provides insights into identifying red flags beyond obstruction, including primary mitral valve disease and the early stages of restrictive or "burnt-out" HCM.
In this episode of In the Thick of It, genetic counselor Matthew Thomas sits down with Dr. Roddy Walsh and Dr. Juan Pablo Ochoa to discuss their groundbreaking research on the genetic architecture of Hypertrophic Cardiomyopathy (HCM). The conversation centers on "Intermediate Effect Variants" (IEVs)—genetic markers that fall between rare, high-impact Mendelian mutations and common, low-impact polygenic risk factors. By utilizing a massive dataset of over 20,000 patients and robust ancestry-matched controls, the researchers demonstrate how these variants contribute to disease severity, age of onset, and wall thickness. This episode explores the practical implications for clinical genetic testing, the necessity of diverse genomic data, and how these findings are shifting the field toward a more quantitative and comprehensive understanding of HCM risk.References: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.074529
In this episode of In the Thick of It, Dr. Betty Raman interviews Dr. Srihari Naidu, Director of the Hypertrophic Cardiomyopathy Medical Center at Westchester Medical Center, to explore what truly defines a "Center of Excellence". Dr. Naidu shares how his philosophy has evolved from a structural focus on advanced imaging and surgical tools to a patient-centered approach that prioritizes individualized care and a multidisciplinary "heart team". The discussion highlights the critical role of specialized centers in navigating complex differential diagnoses—such as amyloidosis or mitochondrial HCM—and the importance of shared decision-making in sudden cardiac death risk stratification. Dr. Naidu also provides a practical roadmap for clinicians looking to establish regional HCM services, emphasizing the necessity of robust echo protocols and strong collaborative networks for advanced procedures.
In this episode of In the Thick of It, hosts Dr. Betty Raman and Dr. James MacNamara welcome Professor Martin Maron, Director of the Hypertrophic Cardiomyopathy Center at Lahey Hospital & Medical Center, to discuss the innovative FORTITUDE-HCM study. This Phase 2b trial focuses on the symptomatic non-obstructive HCM population—a group considered to have one of the greatest unmet treatment needs in the field. The conversation explores the unique mechanism of ninerafaxstat, a metabolic modulator that shifts energy utilization from fatty acids to glucose to improve cardiac energetics and diastolic relaxation. Professor Maron highlights the promising results from the earlier IMPROVE-HCM trial, details the 12-week design of the current study, and speculates on a future where "combination therapy" becomes the standard of care for complex HCM cases.
In this episode of In the Thick of It, Dr. James MacNamara sits down with Dr. Sharlene Day, Director of Translational Research at the University of Pennsylvania, to discuss the groundbreaking SONATA trial. This double-blind, placebo-controlled clinical trial is evaluating the safety and efficacy of sotagliflozin—a dual SGLT1 and SGLT2 inhibitor—in patients with both obstructive and non-obstructive hypertrophic cardiomyopathy. Dr. Day details the trial's unique design, its primary endpoint of improving the Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and the fascinating metabolic mechanisms that may allow these drugs to reduce the heart's workload. The conversation also covers the safety protocols for monitoring outflow tract obstruction and the potential pleiotropic benefits of SGLT2 inhibitors beyond traditional heart failure management.
Dr. James MacNamara and Dr. Betty Raman recap the latest annual Hypertrophic Cardiomyopathy Society (HCMS) meeting held in New Orleans. The discussion emphasizes that HCM care is a "team sport," involving a multidisciplinary coalition of physicians, pharmacists, and advanced practice providers. Key highlights include a deep dive into Professor Hugh Watkins' lecture on the future of gene therapy and the impact of polygenic risk scores on disease penetrance. They also explore the evolving landscape of HCM treatment—comparing the roles of cardiac myosin inhibitors versus surgical interventions—and share promising new data on the safety and efficacy of moderate-intensity exercise for non-obstructive patients.
How can echocardiographers improve the accuracy and confidence of hypertrophic cardiomyopathy diagnosis? In this episode of In the Thick of It, sonographers Amy Dillenbeck and Brad Mehl explore the essential role of echocardiography in evaluating HCM, sharing best practices for optimizing imaging techniques, Doppler assessment, and contrast use. They discuss the most common challenges in detecting HCM, how to train sonographers to recognize subtle diagnostic clues, and strategies to avoid misinterpretation. Whether you're a seasoned clinician or new to HCM imaging, this episode offers valuable insights into refining echocardiographic evaluation for better patient outcomes.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
How do we determine which hypertrophic cardiomyopathy patients are at the highest risk for sudden cardiac death? In this episode of In the Thick of It, Dr. Steve Ommen and Dr. Mark Link take a deep dive into the role of non-sustained ventricular tachycardia (NSVT) in risk assessment and ICD decision-making. They discuss how age, VT duration, and other clinical factors influence risk stratification, as well as the evolving guidelines on ICD placement. The conversation also covers the latest advancements in device technology and the nuances of selecting the right ICD for each patient. Don’t miss this essential discussion on refining risk assessment and improving outcomes in HCM care.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
How can late gadolinium enhancement (LGE) on cardiac MRI help predict sudden cardiac death risk in hypertrophic cardiomyopathy? In this episode of In the Thick of It, Dr. Christopher Kramer and Dr. Raymond Chan explore the clinical significance of LGE, from its role in ICD decision-making to the challenges of scar quantification. They discuss how to differentiate true myocardial scar from artifacts, the evolving guidelines on LGE thresholds, and the implications of advanced imaging techniques for HCM management. Tune in for expert insights on integrating LGE into risk assessment and optimizing patient care.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
How do hypertrophic cardiomyopathy and aortic valve disease intersect, and what makes managing these patients so challenging? In this episode of In the Thick of It, Dr. Srihari Naidu and Dr. Megan Coylewright explore the complexities of aortic valve replacement (TAVR) in patients with HCM. What challenges arise when HCM patients undergo aortic valve replacement, and how can these risks be mitigated? They discuss the risks of left ventricular outflow tract obstruction, strategies to optimize patient outcomes, and the importance of distinguishing HCM from other conditions like amyloidosis. Tune in to learn about the role of advanced imaging, careful patient selection, and multidisciplinary heart teams in managing these overlapping conditions effectively.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
How has genetic testing transformed the understanding and care of hypertrophic cardiomyopathy? In this episode of In the Thick of It, Dr. Victoria Parikh and genetic counselor Tia Moscarello from the Stanford Center for Inherited Cardiovascular Disease explore the powerful role of genetics in HCM diagnosis, family screening, and treatment. They discuss groundbreaking advancements like gene therapy, precision medicine, and the evolving understanding of variants of uncertain significance (VUS). Tune in to learn how genetic insights are driving early detection, personalized therapies, and even potential cures for HCM, offering hope for patients and their families.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
What are left ventricular apical aneurysms, and why do they pose such a high risk in hypertrophic cardiomyopathy patients? In this episode of In the Thick of It, Dr. Ethan Rowin and Dr. Jeffrey Geske delve into this rare but critical HCM phenotype. They discuss how to accurately define and detect apical aneurysms, the importance of advanced imaging techniques like contrast echocardiography and cardiac MRI, and the elevated risks of sudden cardiac death and stroke these patients face. This insightful conversation also provides insights into the evolving guidelines for ICD placement and the nuanced role of aneurysm size in risk stratification. Don’t miss this deep dive into one of HCM’s most challenging presentations.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
Why is early detection of hypertrophic cardiomyopathy in children so critical for effective treatment? In this episode of In the Thick of It, Dr. Matthew Martinez sits down with pediatric cardiologist Dr. Tess Saarel to explore the unique challenges of managing HCM in young patients. They discuss the importance of personalized risk assessments, the role of genetics in tailoring care, and the collaborative efforts needed to improve outcomes in pediatric HCM. Join them for an insightful conversation on the evolving landscape of pediatric cardiology in HCM care.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
What makes managing common conditions like hypertension and sleep apnea uniquely challenging in hypertrophic cardiomyopathy patients? In this episode of In the Thick of It, Dr. Michael Ayers and Dr. Robyn Bryde tackle the complexities of treating comorbidities such as obesity and type 2 diabetes within the context of HCM. They delve into how obstructive physiology impacts treatment choices and share key considerations for surgical clearance, all aimed at optimizing patient outcomes. Tune in for practical insights into managing the multifaceted health needs of HCM patients.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
What does it take for healthcare providers to meet the unique needs of HCM patients experiencing AFib? In this episode, Dr. Ethan Rowin and Dr. Jose Joglar delve into the critical topic of atrial fibrillation (AFib) in patients with hypertrophic cardiomyopathy (HCM). They discuss the heightened risk of stroke associated with AFib, the necessity for prompt anticoagulation, and the complexities of maintaining rhythm control. Tune in to gain pivotal insights into effective treatment strategies, including anti-arrhythmic medications and left atrial appendage closure devices, and discover the importance of comprehensive care and lifestyle management to improve outcomes for HCM patients facing AFib. Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
In today’s episode of In the Thick Of It, Dr. Anna Woo is joined by Dr. Sharon Cresci for a conversation on hypertrophic cardiomyopathy and its genetic implications. What role does genetic testing play in identifying familial variants and whether inheriting a pathogenic variant will lead to disease? Learn about the importance of genetic testing, lifelong serial screening, collaborative treatment approaches, and the processes of educating patients and families about HCM. Tune in as these experts provide insights on vigilance, follow-up care, and informed decision-making in HCM management.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
On today's episode of 'In The Thick of It', Dr. Benjamin Van Boxtel welcomes Dr. Daniel Swistel and Dr. Joseph Dearani to discuss Septal Myectomy and mitral valve repair. Why is personalized patient care crucial when managing hypertrophic cardiomyopathy? Tune in as these specialists explore the importance of customized procedures, teamwork across disciplines, ongoing education, and staying abreast of the latest technological advancements in the field. Dr. Swistel and Dr. Dearani also explain the significance of comprehensive evaluations and specialist collaboration in treating HCM. But what obstacles do they encounter in their multidisciplinary efforts? Check out today's episode to discover their approaches to these challenges, and to learn how the latest surgical innovations are transforming treatment options for HCM and beyond.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
On this episode of 'In The Thick of It', Dr. Steve Ommen joins Dr. Matthew Martinez to explain the latest changes and updates to the HCM guidelines. What is the importance of personalized patient care, shared decision-making, and lifestyle adjustments for HCM patients? Find out as Dr. Martinez and Dr. Ommen discuss risk assessment methodologies, effective management strategies for atrial fibrillation, and the evolving landscape of emerging medical therapies for HCM. These seasoned experts also dissect critical information from the new guidelines while drawing attention to key similarities and differences compared to prior guidelines. What impact do these new guidelines have on individuals affected by HCM across all age brackets? Join Dr. Martinez and Dr. Ommen as they explain how these updates aim to align clinical practices with the latest evidence, ensuring personalized and effective management of HCM.Season 2 of In the Thick of It is brought to you by the HCM Society, is supported by sponsorship from Cytokinetics, and is produced by Earfluence.
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