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Researchers nationwide ask for new focus on 'sudden death' heart disorder
Date:9/14/2010

ients can also be significantly disabled by heart failure, and atrial and ventricular tachyarrhythmas. A few medical therapies such as implanting a cardiac defibrillator exist for selected, high-risk patients, but most medical therapies have largely focused on alleviating symptoms of the disease, not on altering its natural history, he says.

Because so little is known about HCM, some have lobbied for mass screening of young athletes, but most physicians feel it is impractical and would lead to a lot of false positives. "A cardiac exam in a general practitioner's office is not very precise, and more detailed examinations such as routine ECGs would likely be prohibitively expensive and might still miss a significant number of children or could needlessly alarm parents and children," he says. "Some children with HCM have only a minor amount of hypertrophy in their hearts but they are still prone to sudden death, and people can experience sudden death before any symptoms of heart trouble occur. Again family history becomes very important in identifying potentials at risk"

Given these issues, the recommendations of the task force are important in identifying mechanisms and, ultimately, developing novel therapies, Dr. Force says.

Among them are to:

  • Define all genetic causes: HCM is caused by hundreds of different mutations in genes that encode components of the sarcomere, the contractile apparatus of cardiac muscle. But knowledge of the full spectrum of genes and mutations in HCM is needed to explain how the disease develops and, thus, how it can be treated. For example, Dr. Force says some mutations lead to heart failure, while others lead to sudden death with little evidence of heart damage.

  • Study the natural history of the disease: Establish a multi-center prospective observational cohort study of HCM that represents a range of mutations. This will provide insights into the diagnosis and progression of HCM that will
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Contact: Rick Cushman
richard.cushman@jefferson.edu
215-955-2240
Thomas Jefferson University
Source:Eurekalert

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