A focused update to the ACC/AHA Hypertrophic Cardiomyopathy (HCM) Clinical Guidelines was released today. The new guidelines update the previous 2020 guidelines for Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy. Today we’ll take a look at what’s changed, as well as some of the key takeaways from the new 2024 HCM Guidelines. Before we dive in, the ACC/AHA Hypertrophic Cardiomyopathy Guidelines Pocket Guide is now available for free online and in the Guideline Central mobile apps. You can access that here.

It’s been roughly 4 years since the previous HCM Guidelines were released, and a lot has changed since that time. Below you will see a breakdown of the key changes and key takeaways. Please note, this list doesn’t represent ALL of the changes to the guidelines. It is meant to highlight some of the changes. To see a full list/comparison of the new recommendations, make sure to check out the full text guideline or the pocket guide (available for free) in the links above or below. Now…let’s get to it! 

HCM Guidelines Key Changes and Takeaways Comparing 2024 vs. 2020

Addition of new recommendations for cardiac myosin inhibitors

  • Cardiac myosin inhibitors are now available to treat patients with symptomatic obstructive HCM. This new class of medication inhibits actin-myosin interaction, thus decreasing cardiac contractility and reducing left ventricular outflow tract obstruction. Mavacamten is currently the only US Food and Drug Administration-approved agent. These agents can be beneficial for patients with obstructive HCM who do not derive adequate symptomatic relief from first-line drug therapy.

Addition co-authoring organizations

  • In addition to the American College of Cardiology (ACC) and the American Heart Association (AHA), the 2024 HCM guidelines are also co-authored by the following organizations:
    • Heart Rhythm Society (HRS)
    • American Medical Society for Sports Medicine (AMSSM)
    • Pediatric & Congenital Electrophysiology Society (PACES)
    • Society for Cardiovascular Magnetic Resonance (SCMR)

Pediatric exercise stress testing

  • A new recommendation was added “In pediatric patients with HCM, regardless of symptom status, exercise stress testing is recommended to determine functional capacity and to provide prognostic information.”

Nonobstructive HCM With Preserved EF

  • A new recommendation was added “For younger (eg, age ≤45 years) patients with nonobstructive HCM due to a pathogenic or likely pathogenic cardiac sarcomere genetic variant, and a mild phenotype, valsartan may be beneficial to slow progression of the disease.”

Recreational Physical Activity and Competitive Athletics

  • A recommendation has been revised and separated into two separate recommendations with additional detail. Also, a new recommendation was added “For most patients with HCM, universal restriction from vigorous physical activity or competitive athletics is not indicated.”

There you have it – a rundown of some of the bigger hypertrophic cardiomyopathy guidelines changes from 2020 to 2024. As a reminder, for a limited time, you can access the HCM Guidelines Pocket Guide free of charge using the links below. Institutional licenses/subscriptions and bulk orders are also available. 

HCM Guidelines Key Changes and Takeaways Comparing 2024 vs. 2020

Stay tuned, as the Heart Rhythm Society (HRS) Annual Conference 2024 is right around the corner, and our conference recap(s) will follow shortly after. We’ll have another exciting guidelines update from ACC/AHA to share in the coming days/weeks. Sign up for alerts and stay informed on the latest published guidelines and articles.

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