RT-29
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Critical evaluation of risk
factor stratification and treatment for the prevention of sudden death in hypertrophic
cardiomyopathy
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William J. McKenna, Perry M.
Elliott.
Department of Cardiological Sciences, St. George's Hospital Medical School, London, UK
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Abstract
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Hypertrophic cardiomyopathy (HCM) is a primary heart
muscle disorder caused by mutations in genes encoding cardiac sarcomeric proteins. While
it has been long recognised that sudden death is a complication of the disease, the
identification and treatment of patients at risk of dying suddenly remains controversial.
Several clinical features associated with an increased risk of sudden death have been
identified, but their relatively modest positive predictive accuracy has been a barrier to
the construction of a clinically useful stratification algorithm. This article briefly
reviews current data on clinical risk stratification and gives a personal perspective on
an integrated approach to the identification of high risk patients and their treatment.
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Key Words
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Hypertrophic cardiomyopathy
markers of sudden death (clinical, ECG), risk factor stratification, programmed electrical
stimulation, treatment of risk factors, R
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