March 24, 2025
April’s Topic is Genetic Testing

Who should have genetic testing, and when?

Suppose you have been diagnosed with HCM through an EKG, echocardiogram, and a visit with a cardiologist. Most experts recommend that you have genetic testing to know for sure why your heart is too thick.


Why does it matter? 

Some hearts look like HCM but have a genetic mutation for one of the HCM spectrum disorders - Amyloidosis, Fabrys, Danon, Sarcoidosis, etc. These disorders are often managed differently from HCM alone, so you need to know if you have one.

HCM is mainly caused by gene mutations (sometimes called variants or markers). Not all HCM is linked to a specific variant, and we believe more mutations will be identified in the future. 

In recent studies at large HCM Centers, about 40% of those tested had a gene mutation known to cause HCM. As of 2023, 60% will not have a mutation currently identified as causing HCM. We still believe that HCM is a genetic disorder that families can pass down - even if the mutation is currently unknown. 


Your genetic test can show one of three results:

  • Positive / Mutation identified (you have a known variant). 
  • Negative / No mutation identified (you do not have a known variant).
  • VUS (a variant of uncertain significance whose meaning is still evolving). It's a bit confusing, but as researchers learn more, a VUS can be reclassified as a positive or negative.


If your genetic test is positive, this information can be used to screen family members to see if they have the same variant. Your children, parents, and siblings can be tested for your variant, and if they don't have it, they can skip clinical tests (echocardiogram, etc.) unless they develop heart symptoms. 


A negative genetic test DOES NOT take away your HCM diagnosis, and it DOES NOT mean that your family can safely avoid clinical screening for HCM (echocardiogram, EKG, and an exam by a cardiologist). Researchers are still discovering variants that may cause HCM and are starting to look into combinations of two or more genetic variants (polygenetic) that could cause HCM. If you do not have a known variant, your close relatives must be screened regularly using clinical tests to see if they develop HCM. 


Once you've gone through our free Intake process, we will invite you to join our Nest education program. For a great explanation of genetic testing in HCM, sign up for the Nest portal when you're invited.


Knowing your mutation may allow gene therapy to treat your HCM in the future. Clinical gene therapy trials for those with a mutation on MYBPC3 have started! We expect other common HCM variants (such as MYH7, etc.) to be included in future clinical trials.


A last thought: many people who test positive for one of the known variants say, "I have the gene for HCM," but this is misleading. They have a mutation on one of many genes that may contribute to HCM.


For more information about genetics and genetic testing, please visit the HCMA website at https://www.4hcm.org/diagnostic-tools/genetic-testing-an-overview.


HCMA Blog

April 15, 2025
It is hard to believe the first quarter of 2025 is in the history books. In the space of hypertrophic cardiomyopathy and thick heart muscle disorders, the distance between the promise and the delivery of a reality freed from burden of disease is closer than it has ever been, not only in the United States but throughout the world. Unfortunately, we are navigating through some challenging health policy times, which will impact a large percentage of those with the diseases we seek to serve. While we navigate these challenging waters together, we remain committed to ensuring safe, accessible, affordable, healthcare while ensuring the rights of those with disabilities are maintained. Last month, I attended two large conferences - one held in Stockholm, Sweden the other Chicago, Illinois. The research communities worldwide are holding their breath, waiting to see how we will move forward, even as we continue to develop new therapies, treatments and, even potentially, cures. It has never been more important to keep research moving, as we are so close to so many amazing improvements in our ability to care for those with thick heart muscle disorders, including HCM in all its forms, Amyloidosis, Fabry’s disease, Danon disease, and RASopathies. There was amazing science presented at the American College of Cardiology, where we warmly welcomed new president, Dr Christopher Kramer, the original director of the hypertrophic cardiomyopathy center at University of Virginia. We look forward to his leadership and wish him well in his challenging tasks ahead. Later this month we will be in Orlando Florida - please register and join us for this wonderful Bighearted warrior tour in person with our friends at AdventHealth and the incomparable Dr. Marcos Hazday. I even understand that there's some carpooling being organized from the Tampa area. If you're interested, reach out to the office and we will connect you. Maybe, the most impactful thing that will happen in the month of April is that we will conduct our second visit to Capitol Hill. Our lead topic this year is something you have heard us talk about at many prior meetings of the HCMA and podcasts; the generic drug quality issue. We are proud to be partnering with David Light, Co-founder and President of Valisure, and retired Colonel Vic Suarez, to ask House and Senate members to support the inspection of all generic drugs purchased by the Department of Defense and the Veterans Administration and make results of these inspections open for public use. Secondly, we are seeking rational oversight of health insurance companies’ abuse of prior authorizations and step therapy requirements. These issues cost an estimated 1.3 billion dollars a year and provide nothing to keep a patient safer or a physician's office running more efficiently. Common sense tells us to not waste money where there is no return. Additionally, prior authorizations and step therapies can keep patients sicker longer, ultimately costing the healthcare system more money. Our briefing will educate Representatives to act in an informed manner when moving policies that impact us all. You can watch us live at our briefing Wednesday April 9th 5:00 to 7:00 p.m. on Vimeo: https://vimeo.com/event/5043266 If you wish to get involved or more informed on any of the issues above, I encourage you to visit the website, 4hcm.org , or reach out to the office and the staff will be happy to assist you. On the day before I head out to Washington DC, I will leave you with this one thought - we have come a really long way in our understanding of HCM over the past 60 years. We have increased the lifespan of those with HCM, through collaborative research and implementation of best practices in an organized fashion throughout this country. We have worked so hard to end suffering for so many, and we are succeeding in our shared goal to outsmart hypertrophic cardiomyopathy and other thick heart muscle disorders. It is important to continue the research into all aspects of these diseases, including the biological, the clinical, burden of disease measurements. System improvements, positive impact of timely diagnosis and treatment, and the value to society of all of these big hearts being here, keeping their families whole. So we're off to DC to try to educate others about what it really means to live in our ecosystem. Best wishes, Lisa
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