Risk stratification for hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a genetic disorder marked by disorganized architecture of myocardial fibers and a wide range of clinical features. The major concern with HCM is sudden cardiac death, which can occur even in asymptomatic individuals. Current risk evaluation methods for HCM have limitations, and no single predictive risk marker has been found. The 2020 and 2022 ESC guidelines incorporated novel imaging risk markers, such as apical aneurysm, left ventricle ejection fraction below 50%, and significant late gadolinium enhancement (LGE), which improved risk stratification. However, there are challenges in quantifying LGE and standardizing imaging protocols and methodologies. Further research, including large-scale genetic studies and the exploration of novel markers and artificial intelligence, is needed to enhance future risk stratification for HCM.