Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor
In Reply: In response to Dr Maron and colleagues,
I value the role of echocardiography in establishing the diagnosis and severity
of HCM. ("ECG" in Table 3 of my article is an unfortunate typographical
error and should be "ECHO"). However, as discussed in the article, some individuals
who inherit a genetic disease known to cause HCM have normal echocardiograms.
Certain mutations that are characterized by mild or subclinical hypertrophy
may be associated with a high incidence of sudden death.1
Hence, the caution that HCM is occasionally difficult to distinguish from
physiologic hypertrophy by echocardiography is correct. In addition to outflow
gradient, cardiac catheterization provides information concerning filling
pressures and cardiac output, hemodynamic indices that are critical in ascertaining
whether a therapy has not only reduced left ventricular outflow obstruction
but also improved indices of left ventricular systolic and diastolic function.
Fananapazir L. Death. JAMA. 1999;282(24):2302-2303. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-24-jbk1222