Risikostratifizierung bei familiärer hypertropher Kardiomyopathie anhand der neuen ESC-Leitlinien

Zusammenfassung

Die hypertrophe Kardiomyopathie (HCM) ist eine vererbbare Erkrankung, die zu einer Verdickung der linksventrikulären Wand mit oder ohne gleichzeitige Obstruktion des linksventrikulären Ausflusstraktes führt. Neben der symptomatischen Therapie ist eine Risikostratifizierung der Patienten mit HCM essentiell, da es bei den Erkrankten zu lebensbedrohlichen ventrikulären Herzrhythmusstörungen kommen kann. 2013 wurde in der HCM-Risk-SCD-Studie anhand von 3675 Patienten mit HCM und über 24 313 Patientenjahren im follow-up ein neues Prädiktionsmodell für den plötzlichen Herztod entwickelt. Dieses Modell wurde so auch in die Leitlinien der Europäischen Gesellschaft für Kardiologie mit aufgenommen. In dieser Übersichtarbeit sollen das Prädiktionsmodell und die daraus resultierenden Empfehlungen einschließlich der damit verbundenen Limitationen und Risiken diskutiert werden.

Abstract

Hypertrophic cardiomyopathy (HCM) is a hereditary disease characterized by left ventricular hypertrophy with or without concomitant outflow tract obstruction. Identification of patients with HCM who are at high risk of sudden cardiac death (SCD) is crucial as those patients are likely to benefit from an implantable cardioverter defibrillator (ICD). Based on the HCM Risk-SCD study published in 2013, that included 3675 HCM patients with 24 313 years of follow up, a new clinical risk prediction model for sudden cardiac death was developed. This model was included in the recently released 2014 ESC guidelines. This review summarizes the changes in the prediction model and the resulting recommendations and discusses potential risks and limitations of the new score.

Schlüsselwörter

Hypertrophe Kardiomyopathie - Risikostratifizierung - HCM-Risk-SCD

Keywords

Hypertrophic cardiomyopathy - risk stratification - HCM-Risk-SCD

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