Medical treatment of hypertrophic cardiomyopathy – What do we know about it today?

Beta-blockers represent a cornerstone of the treatment of symptomatic hypertrophic cardiomyopathy – they are the first-line therapy for obstructive and non-obstructive forms. Sympathetic modulation leads to the deceleration of heart rate at rest and after exertion, and unconvincingly to the improvement of left ventricular diastolic function and obstruction. Medications include also nondihydropyridine calcium channel blockers without significant vasodilatory properties, i.e. verapamil and diltiazem. Other medications used are class IA antiarrhythmic drugs – disopyramide or cibenzoline, which can be administered to patients with obstructive forms when first-line agents have not been effective. Amiodarone and diuretics can be used in special indications. Some other agents including statins are in the stage of clinical investigation.