Hypertrophic Cardiomyopathy in Heart Failure (NYHA Class II–IV) Without LVOT Obstruction
Clinical Scenario
This protocol addresses patients with hypertrophic cardiomyopathy who present with symptomatic heart failure (NYHA functional class II–IV). The defining features of this sub-population are the absence of left ventricular outflow tract (LVOT) obstruction and a left ventricular ejection fraction (LVEF) ≥ 50%.
In this setting, management of heart failure follows guideline-directed recommendations for patients without LVOTO, as outlined in the 2021 ESC Guidelines for acute and chronic heart failure.
Treatment Approach
For patients with progressive ventricular dysfunction that is refractory to medical therapy, the structured protocol addresses advanced interventional options — including mechanical and surgical strategies. The complete sequence of considerations, eligibility criteria, and stepwise approach is in the full protocol.
Full regimen details, decision criteria, and management algorithm available via the link below.
References
DOI: 10.1093/eurheartj/ehad194
- Management of heart failure in patients without LVOTO should follow the recommendations of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, summarized in Section 6.10.2.
- Patients with progressive LV systolic or diastolic dysfunction refractory to medical therapy may be candidates for cardiac transplantation.
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