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Title
Winthrop’s Srihari S. Naidu, MD, Assists Leading Cardiology Associations in the Developement of First Published Naitonal Treatment Guidlines for Rare Heart Condition - Archived
Date
November 9, 2011
Article

The American College of Cardiology (ACC) and American Heart Association (AHA) have released new national guidelines for the diagnosis and treatment of hypertrophic cardiomyopathy (HCM), a genetic cardiac disease that often doesn’t become apparent until  patients are in their 30s or beyond. The guidelines point to the safety and effectiveness of two invasive treatments for the obstructive form of the condition – septal myectomy (open heart surgery) and alcohol septal ablation (ASA). These guidelines will assist cardiologists worldwide in the clinical decision-making process. Prior to development of the new HCM treatment guidelines, there was a lack of consensus in the cardiology community as to the best ways to diagnose, evaluate and treat HCM, as well as considerable debate over indications for septal myectomy and ASA.

“Even when HCM is diagnosed, many physicians don’t know that the field has evolved to include very complex diagnostic and therapeutic options for patients and their families,” said Srihari S. Naidu, MD, FACC, FAHA, FSCAI, Director of Winthrop-University Hospital’s Cardiac Catheterization Laboratory and Hypertrophic Cardiomyopathy Center, who served on the Guideline Writing Committee as one of 13 national experts. “This highlights the need for treatment guidelines and for centers of excellence that offer comprehensive HCM programs and have extensive experience in diagnosing and treating the disease, such as the one at Winthrop-University Hospital.”

Characterized by excessive thickening of the heart muscle, which makes it difficult for the heart to pump blood effectively, HCM is increasingly recognized as a cause of heart failure, chest pain, shortness of breath and premature death in the teen and young adult population.  Indeed, it is the most common cause of sudden cardiac death among athletes.  The disease often goes undiagnosed well into adulthood either with no symptoms, progressively worsening symptoms, or symptoms that don’t even begin to appear until middle age or later in life.

Dr. Naidu is among few cardiac interventionalists trained and experienced in utilizing ASA to treat HCM patients in whom medical therapy has failed. The technique involves the precisely controlled injection of a small amount of pure alcohol into the thickened septum (the dividing wall between the right and left sides of the heart). Since introducing the procedure at Winthrop in 2007, Dr. Naidu has successfully treated dozens of patients – the most annually of any institution in the New York Metro area – and as a result is increasingly asked to lecture on the topic and teach the technique throughout the country.  

The new guidelines will aid in clinical decision making by providing clearer recommendations for diagnosing patients and the range of treatment options that may be available given the patient’s individual condition. Additionally, new treatment algorithms provide visual guides that will aid in treatment decisions and provide recommendations for patients with left ventricular systolic dysfunction, sudden cardiac death risk stratification, screening of first-degree relatives (including genetic testing) and guidance in the management of complications. The guidelines also stress the importance of the establishment of regional multidisciplinary HCM Centers of Excellence. 

Under the leadership of Dr. Naidu, Winthrop’s HCM Center – Long Island’s first and only Hypertrophic Cardiomyopathy Center – has been named a Center of Excellence by the national Hypertrophic Cardiomyopathy Association. The Center’s multidisciplinary team of cardiologists, internal medicine specialists, electrophysiologists, surgeons and pediatric cardiologists provide comprehensive, expert care for HCM patients including the latest options in minimally invasive treatment. In addition to alcohol septal ablation and surgical myectomy, other treatment options for HCM include lifestyle modification counseling, medication, permanent pacemakers, and implantable defibrillators, among others.

The guidelines are published in the current online edition of the Journal of the American College of Cardiology and in Circulation. To access the guidelines, visit http://content.onlinejacc.org/cgi/content/full/j.jacc.2011.06.011

For additional information about HCM and the advanced cardiac services available at Winthrop, visit www.winthrop.org or call 1-866-WINTHROP.

Contact: Leanna Cherry
Publications Specialist
(516) 663-2234
lcherry@winthrop.org
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