{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:21:01Z","timestamp":1789924861815,"version":"4.0.1"},"reference-count":106,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:p xml:lang=\"en\">Once considered rare and essentially untreatable with a grim prognosis and reduced life expectancy, hypertrophic cardiomyopathy (HCM) has evolved substantially over 6 decades. Ultimately, HCM has become a contemporary global disease with pharmacologic and interventional options offering effective personalized treatment for all adverse disease pathways. Striking reduction in HCM\u2010related mortality to \u22640.5%\/year in optimally treated cohorts is now comparable to that expected in the US general population, lower than most other disease risks to living, and 10\u2010fold less than the earliest estimates. The few deaths directly related to HCM are now largely attributable to advanced (end\u2010stage) heart failure in patients with nonobstructive HCM.<\/jats:p>\n                  <jats:p xml:lang=\"en\">Determinants of this transformation to a lower risk disease are evident in hallmark clinical inflection points and breakthroughs, including dedicated HCM programs assembling large clinical databases in which focused (and unfunded) physician\u2010investigators have derived data directly from patients in clinical practice. Evidence\u2010based observational studies report emergence of contemporary treatment strategies enhancing survival: implantable defibrillators prevent arrhythmic sudden death globally with 95% sensitive patient selection using an American Heart Association\/American College Cardiology risk stratification algorithm; low\u2010risk, high\u2010benefit surgical myectomy reverses outflow obstruction and heart failure in &gt;90% with a long\u2010term survival benefit; and aggressive anticoagulation has reduced embolic strokes. Recent novel pharmacologic alternatives (cardiac myosin inhibitors) are proving effective in relieving obstruction\/symptom burden and changing disease management.<\/jats:p>\n                  <jats:p xml:lang=\"en\">These principles and time\u2010tested patient\u2010centered research strategies uniquely tailored to the heterogeneous HCM clinical spectrum are pivotal in providing practice insights, offering a vulnerable population more optimistic prognosis including opportunity to achieve normal longevity not available to prior generations of patients.<\/jats:p>","DOI":"10.1161\/jaha.125.047462","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:28:03Z","timestamp":1774430883000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Evolution and Transformation of Hypertrophic Cardiomyopathy From a High Risk to a Treatable Low Mortality Disease With Contemporary Clinical Research Strategies"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-8670","authenticated-orcid":false,"given":"Barry J.","family":"Maron","sequence":"first","affiliation":[{"name":"HCM Center, Lahey Hospital and Medical Center","place":["Burlington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9410-0920","authenticated-orcid":false,"given":"Steven R.","family":"Ommen","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Cardiovascular Medicine","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4651-9740","authenticated-orcid":false,"given":"Rick A.","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Cardiovascular Medicine","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7994-2460","authenticated-orcid":false,"given":"William J.","family":"McKenna","sequence":"additional","affiliation":[{"name":"University College","place":["London, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5494-366X","authenticated-orcid":false,"given":"Harry","family":"Rakowski","sequence":"additional","affiliation":[{"name":"Toronto General Hospital","place":["Toronto, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-7780","authenticated-orcid":false,"given":"Mark V.","family":"Sherrid","sequence":"additional","affiliation":[{"name":"NYU Langone Health","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1751-9266","authenticated-orcid":false,"given":"Iacopo","family":"Olivotto","sequence":"additional","affiliation":[{"name":"University of Florence","place":["Florence, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Braunwald","sequence":"additional","affiliation":[{"name":"Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9923-3853","authenticated-orcid":false,"given":"Martin S.","family":"Maron","sequence":"additional","affiliation":[{"name":"HCM Center, Lahey Hospital and Medical Center","place":["Burlington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.20.1.1"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.29.5s4.iv-3"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(79)90160-7"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.03.004"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.92.4.785"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.01.019"},{"key":"e_1_3_1_8_2","first-page":"179","article-title":"The natural (and unnatural) history of hypertrophic cardiomyopathy","volume":"35","author":"Shah PM","year":"1974","unstructured":"Shah PM, Adelman AG, Wigle ED, Gorel FL, Burchell HB, Hardarson T, Curiel R, de la Calzada C, Oakley CM, Goodwin JF. The natural (and unnatural) history of hypertrophic cardiomyopathy. Circ Res. 1974;35: Suppl II:179\u2013195.","journal-title":"Circ Res"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000938"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001250"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318223e230"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(03)00941-0"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu284"},{"key":"e_1_3_1_14_2","article-title":"Demographics and clinical implications of a global bibliographic profile for the hypertrophic cardiomyopathy literature over 66\u2009years","author":"Sayed A","year":"1960","unstructured":"Sayed A, Rowin EJ, Maron MS, Maron BJ. Demographics and clinical implications of a global bibliographic profile for the hypertrophic cardiomyopathy literature over 66\u2009years. Int J Cardiol. 1960\u20102025. In press","journal-title":"Int J Cardiol"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.071"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.40.1.3"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1710575"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.045"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.02.061"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.11.021"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.11.035"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2022.07.012"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2023.100337"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.068577"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.12.027"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021095"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.090"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000001606"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00353-3"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.621185"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.4.1091"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm117"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.03.026"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.037047"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.12.044"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.027738"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35833"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-022-00109-3"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2022.05.006"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.04.048"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.124.014023"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.46.2.168"},{"key":"e_1_3_1_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31792-X"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.040"},{"key":"e_1_3_1_46_2","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican102024-bhc7mJocNIdIEkxD7Z0ie"},{"key":"e_1_3_1_47_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26113"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.08.048"},{"key":"e_1_3_1_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.05.064"},{"key":"e_1_3_1_50_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht439"},{"key":"e_1_3_1_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2022.06.007"},{"key":"e_1_3_1_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(95)91267-3"},{"key":"e_1_3_1_53_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002103420601"},{"key":"e_1_3_1_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.10.033"},{"key":"e_1_3_1_55_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.4.405"},{"key":"e_1_3_1_56_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.1391"},{"key":"e_1_3_1_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.06.034"},{"key":"e_1_3_1_58_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.2824"},{"key":"e_1_3_1_59_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab598"},{"key":"e_1_3_1_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.04.042"},{"key":"e_1_3_1_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.101317"},{"key":"e_1_3_1_62_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.005820"},{"key":"e_1_3_1_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.037"},{"key":"e_1_3_1_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.1333"},{"key":"e_1_3_1_65_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.92.9.122"},{"key":"e_1_3_1_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(96)70018-1"},{"key":"e_1_3_1_67_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.90.4.1781"},{"key":"e_1_3_1_68_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021332"},{"key":"e_1_3_1_69_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf560"},{"key":"e_1_3_1_70_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf561"},{"key":"e_1_3_1_71_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.644682"},{"key":"e_1_3_1_72_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.011"},{"key":"e_1_3_1_73_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.04.018"},{"key":"e_1_3_1_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.02.032"},{"key":"e_1_3_1_75_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.011580"},{"key":"e_1_3_1_76_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.862359"},{"key":"e_1_3_1_77_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.023"},{"key":"e_1_3_1_78_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.009796"},{"key":"e_1_3_1_79_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.065037"},{"key":"e_1_3_1_80_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304276"},{"key":"e_1_3_1_81_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0735-1097(01)01727-2"},{"key":"e_1_3_1_82_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.05.038"},{"key":"e_1_3_1_83_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198903233201201"},{"key":"e_1_3_1_84_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.7.650"},{"key":"e_1_3_1_85_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.011207"},{"key":"e_1_3_1_86_2","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(90)90274-i"},{"key":"e_1_3_1_87_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033200"},{"key":"e_1_3_1_88_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.110.223834"},{"key":"e_1_3_1_89_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199204233261703"},{"key":"e_1_3_1_90_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033349"},{"key":"e_1_3_1_91_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2412392"},{"key":"e_1_3_1_92_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.100922"},{"key":"e_1_3_1_93_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.01.040"},{"key":"e_1_3_1_94_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90337-9"},{"key":"e_1_3_1_95_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.4221"},{"key":"e_1_3_1_96_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017633"},{"key":"e_1_3_1_97_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.04.027"},{"key":"e_1_3_1_98_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.4534"},{"key":"e_1_3_1_99_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.0789"},{"key":"e_1_3_1_100_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2401424"},{"key":"e_1_3_1_101_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf364"},{"key":"e_1_3_1_102_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.09.003"},{"key":"e_1_3_1_103_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2504654"},{"key":"e_1_3_1_104_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.037639"},{"key":"e_1_3_1_105_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.01.012"},{"key":"e_1_3_1_106_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.03.387"},{"key":"e_1_3_1_107_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2022.07.033"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.047462","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:45:48Z","timestamp":1789551948000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.047462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":106,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,6,16]]}},"alternative-id":["10.1161\/JAHA.125.047462"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.047462","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"assertion":[{"value":"2025-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e047462"}}