{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:28:33Z","timestamp":1769059713351,"version":"3.49.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Patients with primary left ventricular hypertrophy (LVH) often experience a diagnostic delay of several years, largely related to fragmented knowledge among different specialties and the rarity of the conditions. We developed and validated a digital support tool to guide the physician in the differential diagnostic process of patients presenting with primary LVH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A total of 818 patients with definitive diagnosis of sarcomeric hypertrophic cardiomyopathy (HCM) or one of its phenocopies [479 (62%) males, 48 \u00b1 24 years] were included. Pre-specified disease-specific red flags (RFs) were categorized into five domains: family history, signs\/symptoms, electrocardiography, echocardiographic, and laboratory. Each patient\u2019s characteristics were inserted by two independent and blind investigators into the app. The diagnostic outcome, based on the presence\/absence of RF, was categorized as follows: (i) most likely diagnosis, (ii) possible diagnosis, and (iii) less likely diagnosis. A total of 2979 RFs were identified and non-sarcomeric phenocopies exhibited a higher RF burden than sarcomeric HCM (3.9 vs. 2.7 RFs per patient, P = 0.007), with systemic features and extracardiac findings being strong predictors of non-sarcomeric disease. Thick-Heart App correctly classified 93% of cases into the most likely diagnosis category (sensitivity of 88\u2013100%, specificity 97%). The positive predictive value (PPV) for TTR amyloidosis reached 92%, while Friedrich\u2019s ataxia was correctly identified in all cases (PPV = 100%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Thick-Heart App correctly classified 93% of cases into the most-likely diagnosis category (sensitivity 88\u2013100%, specificity 97%). Our study underscores the potential clinical value of digital decision support tools to enable timelier identification of specific cardiomyopathies, by promoting awareness in non-reference settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztaf105","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T22:27:20Z","timestamp":1758320840000},"source":"Crossref","is-referenced-by-count":0,"title":["Development of a smartphone-based app to support the differential diagnosis in patients with primary left ventricular hypertrophy"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-204X","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Maurizi","sequence":"first","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Largo Brambilla 3, Florence 50121 ,","place":["Italy"]},{"name":"Service of Cardiology, University Hospital of Lausanne (CHUV) , Lausanne ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Monda","sequence":"additional","affiliation":[{"name":"Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019, Monaldi Hospital , Naples ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6830-4292","authenticated-orcid":false,"given":"Maurizio","family":"Pieroni","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Largo Brambilla 3, Florence 50121 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0295-0440","authenticated-orcid":false,"given":"Elena","family":"Biagini","sequence":"additional","affiliation":[{"name":"Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna , Bologna 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,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Largo Brambilla 3, Florence 50121 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Antiochos","sequence":"additional","affiliation":[{"name":"Service of Cardiology, University Hospital of Lausanne (CHUV) , Lausanne ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-0389","authenticated-orcid":false,"given":"Ioannis","family":"Skalidis","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris Sud , Mancy, Paris 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,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9143-3597","authenticated-orcid":false,"given":"Francesca","family":"Girolami","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Meyer Children\u2019s Hospital IRCCS , Florence ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Cecchi","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Largo Brambilla 3, Florence 50121 ,","place":["Italy"]},{"name":"AICARM Onlus APS , Florence ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Cappelli","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital , Largo Brambilla 3, Florence 50121 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perry M","family":"Elliott","sequence":"additional","affiliation":[{"name":"Centre for Heart Muscle Disease, Institute of Cardiological Sciences, University College London and St. Bartholomew\u2019s Hospital , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Kaski","sequence":"additional","affiliation":[{"name":"Centre for Paediatric Inherited and Rare Cardiovascular Disease, Institute of Cardiovascular Science, University College London , London ,","place":["UK"]},{"name":"Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Limongelli","sequence":"additional","affiliation":[{"name":"Inherited and Rare Cardiovascular Diseases Unit, Department of Translational Medical Sciences, University of Campania \u2018Luigi Vanvitelli\u2019, Monaldi Hospital , Naples 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