Patient advocates Hannah and Bethany Keime from HeartCharged sit down with Dr. John Fritzlen to discuss the long-term journey of living with hypertrophic cardiomyopathy (HCM). The conversation covers the progressive nature of the condition, including the onset of heart failure symptoms, atrial fibrillation, and myocardial remodeling over decades, as well as how advanced diagnostics like cardiopulmonary exercise testing (CPET) help clinicians track subtle declines. Dr. Fritzlen shares tailored approaches for counseling young or newly diagnosed patients, emphasizing the importance of active lifestyle management and proactive treatment strategies like cardiac myosin inhibitors. Additionally, the group addresses the critical clinical and lifestyle factors involved in selecting implantable cardioverter-defibrillators (ICDs), detailing the durability advantages of subcutaneous (S-ICD) and extravascular (EV-ICD) systems for active, younger populations.

Dr. Florian Rader joins Dr. Louise Bjerregaard to discuss a groundbreaking randomized, double-blind, triple-crossover trial that challenges the long-standing "mantra" of using beta blockers as first-line therapy for non-obstructive hypertrophic cardiomyopathy (HCM). Dr. Bjerregaard explains how the study compared bisoprolol, verapamil, and placebo, revealing that bisoprolol actually resulted in a significant reduction in functional capacity and a worsening of patient symptoms as measured by the KCCQ score. The conversation explores why slowing the heart rate may be detrimental to patients with "stiff hearts" who rely on chronotropic competence to maintain cardiac output, and why calcium channel blockers like verapamil might be a more favorable alternative for symptom management. This episode is essential listening for clinicians looking to move beyond expert opinion toward evidence-based, personalized care for their non-obstructive HCM patients.

View the results of the trial here: https://www.jacc.org/doi/10.1016/j.jacc.2025.11.028

Dr. John Fritzlen sits down with Dr. Hunain Shiwani to discuss a paradigm shift in diagnosing hypertrophic cardiomyopathy (HCM). For 50 years, the medical community has relied on a static 15mm wall thickness threshold that fails to account for individual body size, age, and biological sex; a bias that often leaves female patients underdiagnosed. Dr. Shiwani details his team’s groundbreaking research using machine learning and cardiac MRI data from the UK Biobank to establish personalized diagnostic thresholds. Discover how these demographic-based indexes can improve clinical accuracy, reduce diagnostic bias, and empower clinicians through tools like the HCM Calculator to provide more equitable care for patients on the margins of traditional criteria.

References:
HCM Calculator: https://hcmcalculator.com/