vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v24i3.2908vsp-3780Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONS«Мышечный мостик» как возможный фактор риска внезапной сердечной смерти ребенка с гипертрофической кардиомиопатией: клинический случай“Muscle Bridge” as a Possible Risk Factor for Sudden Cardiac Death in a Child with Hypertrophic Cardiomyopathy: Case Studyhttps://orcid.org/0000-0002-2290-0013БалыковаЛ. А.BalykovaLarisa A.

Балыкова Лариса Александровна - член-корреспондент Российской академии наук, доктор медицинских наук, профессор кафедры педиатрии и проректор по инновационной деятельности в сфере биотехнологии и медицины Национального исследовательского МГУ им. Н.П. Огарёва.

430005, Саранск, ул. Большевистская, д. 68

тел.: +7 (8342) 27-27-88

Saransk

larisabalykova@yandex.ruhttps://orcid.org/0000-0002-5273-6859ЛеонтьеваИ. В.LeontyevaIrina V.

Москва

Moscow

https://orcid.org/0000-0001-8635-6216МиклашевичИ. М.MiklashevichIrina M.

Москва

Moscow

https://orcid.org/0000-0003-2466-7865ТермосесовС. A.ThermosesovSergey A.

Москва

Moscow

КраснопольскаяА. В.KrasnopolskayaAnna V.

Саранск

Saransk

https://orcid.org/0000-0002-9049-5662ШирманкинаМ. В.ShirmankinaMarina V.

Саранск

Saransk

https://orcid.org/0000-0001-6207-5196ЩёкинаН. В.ShchekinaNatalya V.

Саранск

Saransk

https://orcid.org/0000-0002-6899-6284ИсаеваЮ. С.IsaevaYuliya S.

Москва

Moscow

https://orcid.org/0009-0004-5017-8170ШкуринП. А.ShkurinPavel A.

Саранск

Saransk

Национальный исследовательский Мордовский государственный университет им. Н.П. Огарёва; Детская республиканская клиническая больницаРоссияN.P. Ogarev Mordovia State University; Republican Children’s Clinical HospitalRussian FederationНаучно-исследовательский клинический институт педиатрии и детской хирургии им. акад. Ю.Е. Вельтищева; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова (Пироговский Университет)РоссияVeltischev Research and Clinical Institute for Pediatrics; Pirogov Russian National Research Medical UniversityRussian FederationНациональный исследовательский Мордовский государственный университет им. Н.П. ОгарёваРоссияN.P. Ogarev Mordovia State UniversityRussian FederationДетская республиканская клиническая больницаРоссияRepublican Children’s Clinical HospitalRussian Federation202522072025243193202Copyright © Балыкова Л.А., Леонтьева И.В., Миклашевич И.М., Термосесов С.A., Краснопольская А.В., Ширманкина М.В., Щёкина Н.В., Исаева Ю.С., Шкурин П.А., 20252025Балыкова Л.А., Леонтьева И.В., Миклашевич И.М., Термосесов С.A., Краснопольская А.В., Ширманкина М.В., Щёкина Н.В., Исаева Ю.С., Шкурин П.А.Balykova L.A., Leontyeva I.V., Miklashevich I.M., Thermosesov S.A., Krasnopolskaya A.V., Shirmankina M.V., Shchekina N.V., Isaeva Y.S., Shkurin P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/3780

Обоснование. Гипертрофическая кардиомиопатия (ГКМП) является одной из наиболее частых причин внезапной сердечной смерти (ВСС) молодых людей в возрасте до 35 лет. При этом ВСС может быть первым и единственным клиническим проявлением заболевания у детей. Описание клинического случая. Пациентка с ГКМП и низким риском сердечных событий перенесла первый эпизод ВСС в возрасте 12 лет 4 мес на фоне физической нагрузки. Заподозрена острая ишемия миокарда вследствие аномалии коронарных артерий — «мышечного мостика», которая явилась триггером злокачественных желудочковых аритмий, приведших к остановке сердца. Для вторичной профилактики ВСС проведена установка имплантируемого кардиовертера-дефибриллятора (ИКД). Однако заболевание прогрессировало, ребенок перенес еще два эпизода остановки кровообращения вследствие фибрилляции желудочков, купированных разрядом ИКД и реанимационными мероприятиями. Проведена коррекция лекарственной терапии и режимов ИКД. Реваскуляризация миокарда не проведена на основании высокого операционного риска. Заключение. Показаны трудности ведения пациентки с ГКМП, осложненной развитием острой ишемии миокарда вследствие врожденной аномалии коронарных артерий. Согласно традиционной оценке, ишемия миокарда у детей не считается «большим» фактором риска ВСС. Однако, как показало наше наблюдение, она может быть триггером жизнеугрожающих желудочковых аритмий и неблагоприятно влиять на прогноз ГКМП.

Background. Hypertrophic cardiomyopathy (HCM) is one of the most common causes of sudden cardiac death (SCD) in young adults under the age of 35. SCD may be the first and only clinical manifestation of the disease in children. Case presentation. Female patient with HCM and low risk of cardiac events suffered the first episode of SCD associated with physical activity at the age of 12 years 4 months. Acute myocardial ischemia was suspected due to abnormal coronary arteries, “muscle bridge”, that was the trigger of malignant ventricular arrhythmias leading to cardiac arrest. Implantable cardioverter defibrillator (ICD) was installed for secondary SCD prevention. However, the disease has progressed, and the child suffered two more episodes due to ventricular fibrillation, managed by ICD and resuscitation measures. Drug therapy and ICD regimens were adjusted. Myocardial revascularization was not performed due to high surgical risk. Conclusion. Difficulties in management of patient with HCM complicated with acute myocardial ischemia due to congenital coronary arteries anomaly are presented. Myocardial ischemia is not considered as “large” risk factor for SCD in children (according to traditional evaluation). However, it can be a trigger for life-threatening ventricular arrhythmias and negatively affect HCM prognosis as it has been shown in our observation.

детигипертрофическая кардиомиопатиясинкопальные состояниявнезапная сердечная смерть«мышечные мостики»childrenhypertrophic cardiomyopathysyncopesudden cardiac death“muscle bridges”ReferencesArghami A, Dearani JA, Said SM, et al. Hypertrophic cardiomyopathy in children. Ann Cardiothorac Surg. 2017;6(4): 376-385. doi: https://doi.org/10.21037/acs.2017.07.04Arghami A, Dearani JA, Said SM, et al. Hypertrophic cardiomyopathy in children. Ann Cardiothorac Surg. 2017;6(4): 376-385. doi: https://doi.org/10.21037/acs.2017.07.04Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC Guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: executive summary: A report of the American College of Cardiology / American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e533-e5357. doi: https://doi.org/10.1161/cir.0000000000000938Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC Guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: executive summary: A report of the American College of Cardiology / American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e533-e5357. doi: https://doi.org/10.1161/cir.0000000000000938Tsatsopoulou A, Protonotarios I, Xylouri Z, et al. Cardiomyopathies in children: An overview. Hellenic J Cardiol. 2023;72:43-56. doi: https://doi.org/10.1016/j.hjc.2023.02.007Tsatsopoulou A, Protonotarios I, Xylouri Z, et al. Cardiomyopathies in children: An overview. Hellenic J Cardiol. 2023;72:43-56. doi: https://doi.org/10.1016/j.hjc.2023.02.007Colan SD, Lipshultz SE, Lowe AM, et al. Epidemiology and cause-specific outcome of hypertrophic cardiomyopathy in children: findings from the Pediatric Cardiomyopathy Registry. Circulation. 2007;115(6):773-781. doi: https://doi.org/10.1161/CIRCULATIONAHA.106.621185Colan SD, Lipshultz SE, Lowe AM, et al. Epidemiology and cause-specific outcome of hypertrophic cardiomyopathy in children: findings from the Pediatric Cardiomyopathy Registry. Circulation. 2007;115(6):773-781. doi: https://doi.org/10.1161/CIRCULATIONAHA.106.621185Möbius-Winkler MN, Laufs U, Lenk K. The Diagnosis and Treatment of Hypertrophic Cardiomyopathy. Dtsch Arztebl Int. 2024;121(24):805-811. doi: https://doi.org/10.3238/arztebl.m2024.0196Möbius-Winkler MN, Laufs U, Lenk K. The Diagnosis and Treatment of Hypertrophic Cardiomyopathy. Dtsch Arztebl Int. 2024;121(24):805-811. doi: https://doi.org/10.3238/arztebl.m2024.0196Lipshultz SE, Law YM, Asante-Korang A, et al. Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American Heart Association. Circulation. 2019;140(1):e9-e68. doi: https://doi.org/10.1161/CIR.0000000000000682Lipshultz SE, Law YM, Asante-Korang A, et al. Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American Heart Association. Circulation. 2019;140(1):e9-e68. doi: https://doi.org/10.1161/CIR.0000000000000682Monda E, Palmiero G, Lioncino M, et al. Multimodality imaging in cardiomyopathies with hypertrophic phenotypes. J Clin Med. 2022;11(3):868. doi: https://doi.org/10.3390/jcm11030868Monda E, Palmiero G, Lioncino M, et al. Multimodality imaging in cardiomyopathies with hypertrophic phenotypes. J Clin Med. 2022;11(3):868. doi: https://doi.org/10.3390/jcm11030868Леонтьева И.В. Внезапная сердечная смерть при гипертрофической кардиомиопатии у детей, подходы к профилактике // Российский вестник перинатологии и педиатрии. — 2024. — Т. 69. — № 3. — С. 6-18. — doi: https://doi.org/10.21508/1027-4065-2024-69-3-6-18Leontyeva IV. Sudden cardiac death in children with hypertrophic cardiomyopathy: approaches to prevention. Rossiyskiy Vestnik Perinatologii i Pediatrii = Russian Bulletin of Perinatology and Pediatrics. 2024;69(3):6-18. (In Russ). doi: https://doi.org/10.21508/1027-4065-2024-69-3-6-18Deraz SE, Esmat OD, El-Hmid RGA, Amin SA. Evaluation of diastolic dysfunction in children with hypertrophic cardiomyopathy and its relationship with development of myocardial fibrosis. Egypt Heart J. 2023;75(1):54. doi: https://doi.org/10.1186/s43044-023-00382-1Deraz SE, Esmat OD, El-Hmid RGA, Amin SA. Evaluation of diastolic dysfunction in children with hypertrophic cardiomyopathy and its relationship with development of myocardial fibrosis. Egypt Heart J. 2023;75(1):54. doi: https://doi.org/10.1186/s43044-023-00382-1Alexander PMA, Nugent AW, Daubeney PEF, et al. Longterm outcomes of hypertrophic cardiomyopathy diagnosed during childhood: results from a national population-based study. Circulation. 2018;138(1):29-36. doi: https://doi.org/10.1161/CIRCULATIONAHA.117.028895Alexander PMA, Nugent AW, Daubeney PEF, et al. Longterm outcomes of hypertrophic cardiomyopathy diagnosed during childhood: results from a national population-based study. Circulation. 2018;138(1):29-36. doi: https://doi.org/10.1161/CIRCULATIONAHA.117.028895Mascia G, Crotti L, Groppelli A, et al. Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and metaanalysis. Int J Cardiol. 2022;357:88-94. doi: https://doi.org/10.1016/j.ijcard.2022.03.028Mascia G, Crotti L, Groppelli A, et al. Syncope in hypertrophic cardiomyopathy (part I): An updated systematic review and metaanalysis. Int J Cardiol. 2022;357:88-94. doi: https://doi.org/10.1016/j.ijcard.2022.03.028Norrish G, Field E, Mcleod K, et al. Clinical presentation and survival of childhood hypertrophic cardiomyopathy: a retrospective study in United Kingdom. Eur Heart J. 2019;40(12):986-993. doi: https://doi.org/10.1093/eurheartj/ehy798Norrish G, Field E, Mcleod K, et al. Clinical presentation and survival of childhood hypertrophic cardiomyopathy: a retrospective study in United Kingdom. Eur Heart J. 2019;40(12):986-993. doi: https://doi.org/10.1093/eurheartj/ehy798Cai ML, Zhong GQ. Hypertrophic Obstructive Cardiomyopathy with SAM Phenomenon: A Case Report and Literature Review. Cardiol Cardiovasc Med. 2022;6:515-522. doi: https://doi.org/10.26502/fccm.92920293Cai ML, Zhong GQ. Hypertrophic Obstructive Cardiomyopathy with SAM Phenomenon: A Case Report and Literature Review. Cardiol Cardiovasc Med. 2022;6:515-522. doi: https://doi.org/10.26502/fccm.92920293Kotkar KD, Said SM, Dearani JA, Schaff HV. Hypertrophic obstructive cardiomyopathy: the Mayo Clinic experience. Ann Cardiothorac Surg. 2017;6(4):329-336. doi: https://doi.org/10.21037/acs.2017.07.03Kotkar KD, Said SM, Dearani JA, Schaff HV. Hypertrophic obstructive cardiomyopathy: the Mayo Clinic experience. Ann Cardiothorac Surg. 2017;6(4):329-336. doi: https://doi.org/10.21037/acs.2017.07.03Miron A, Lafreniere-Roula M, Steve Fan CP, et al. A validated model for sudden cardiac death risk prediction in pediatric hypertrophic cardiomyopathy. Circulation. 2020;142(3):217-229. doi: https://doi.org/10.1161/CIRCULATIONAHA.120.047235Miron A, Lafreniere-Roula M, Steve Fan CP, et al. A validated model for sudden cardiac death risk prediction in pediatric hypertrophic cardiomyopathy. Circulation. 2020;142(3):217-229. doi: https://doi.org/10.1161/CIRCULATIONAHA.120.047235Maurizi N, Passantino S, Spaziani G, et al. Long-term Outcomes of Pediatric-Onset Hypertrophic Cardiomyopathy and Age-Specific Risk Factors for Lethal Arrhythmic Events. JAMA Cardiol. 2018;3(6): 520-525. doi: https://doi.org/10.1001/jamacardio.2018.0789Maurizi N, Passantino S, Spaziani G, et al. Long-term Outcomes of Pediatric-Onset Hypertrophic Cardiomyopathy and Age-Specific Risk Factors for Lethal Arrhythmic Events. JAMA Cardiol. 2018;3(6): 520-525. doi: https://doi.org/10.1001/jamacardio.2018.0789Norrish G, Cantarutti N, Pissaridou E, et al. Risk factors for sudden cardiac death in childhood hypertrophic cardiomyopathy: A systematic review and meta-analysis. Eur J Prev Cardiol. 2017;24(11): 1220-1230. doi: https://doi.org/10.1177/2047487317702519Norrish G, Cantarutti N, Pissaridou E, et al. Risk factors for sudden cardiac death in childhood hypertrophic cardiomyopathy: A systematic review and meta-analysis. Eur J Prev Cardiol. 2017;24(11): 1220-1230. doi: https://doi.org/10.1177/2047487317702519Hong Y, Su WW, Li X. Risk factors of sudden cardiac death in hypertrophic cardiomyopathy. Curr Opin Cardiol. 2022;37(1):15-21. doi: https://doi.org/10.1097/HCO.0000000000000939Hong Y, Su WW, Li X. Risk factors of sudden cardiac death in hypertrophic cardiomyopathy. Curr Opin Cardiol. 2022;37(1):15-21. doi: https://doi.org/10.1097/HCO.0000000000000939Petryka-Mazurkiewicz J, Ziolkowska L, Kowalczyk-Domagala M, et al. LGE for Risk Stratification in Primary Prevention in Children With HCM. JACC Cardiovasc Imaging. 2020;13(12):2684-2686. doi: https://doi.org/10.1016/j.jcmg.2020.06.009Petryka-Mazurkiewicz J, Ziolkowska L, Kowalczyk-Domagala M, et al. LGE for Risk Stratification in Primary Prevention in Children With HCM. JACC Cardiovasc Imaging. 2020;13(12):2684-2686. doi: https://doi.org/10.1016/j.jcmg.2020.06.009Sedaghat-Hamedani F, Kayvanpour E, Tugrul OF, et al. Clinical outcomes associated with sarcomere mutations in hypertrophic cardiomyopathy: a meta-analysis on 7675 individuals. Clin Res Cardiol. 2018;107(1):30-41. doi: https://doi.org/10.1007/s00392-017-1155-5Sedaghat-Hamedani F, Kayvanpour E, Tugrul OF, et al. Clinical outcomes associated with sarcomere mutations in hypertrophic cardiomyopathy: a meta-analysis on 7675 individuals. Clin Res Cardiol. 2018;107(1):30-41. doi: https://doi.org/10.1007/s00392-017-1155-5Arbelo E, Protonotarios A, Gimeno JR, et al. ESC Scientific Document Group2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023;44(37):3503-3626. doi: https://doi.org/10.1093/eurheartj/ehadArbelo E, Protonotarios A, Gimeno JR, et al. ESC Scientific Document Group2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023;44(37):3503-3626. doi: https://doi.org/10.1093/eurheartj/ehadMaron BJ, Desai MY, Nishimura RA, et al. Diagnosis and Evaluation of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review. J Am Coll Cardiol. 2022;79(4):372-389. doi: https://doi.org/10.1016/j.jacc.2021.12.002Maron BJ, Desai MY, Nishimura RA, et al. Diagnosis and Evaluation of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review. J Am Coll Cardiol. 2022;79(4):372-389. doi: https://doi.org/10.1016/j.jacc.2021.12.002Bohm P, Barra S, Weizman O, et al. Sudden Cardiac Arrest During Sports in Children and Adolescents. Circulation. 2024;149(10): 794-796. doi: https://doi.org/10.1161/CIRCULATIONAHA.123.064739Bohm P, Barra S, Weizman O, et al. Sudden Cardiac Arrest During Sports in Children and Adolescents. Circulation. 2024;149(10): 794-796. doi: https://doi.org/10.1161/CIRCULATIONAHA.123.064739Shafqat A, Shaik A, Koritala S, et al. Contemporary review on pediatric hypertrophic cardiomyopathy: insights into detection and management. Front Cardiovasc Med. 2024;10:1277041. doi: https://doi.org/10.3389/fcvm.2023.1277041Shafqat A, Shaik A, Koritala S, et al. Contemporary review on pediatric hypertrophic cardiomyopathy: insights into detection and management. Front Cardiovasc Med. 2024;10:1277041. doi: https://doi.org/10.3389/fcvm.2023.1277041Xia K, Sun D, Wang R, Zhang Y. Factors associated with the risk of cardiac death in children with hypertrophic cardiomyopathy: a systematic review and meta-analysis. Heart Lung. 2022;52: 26-36. doi: https://doi.org/10.1016/j.hrtlng.2021.11.006Xia K, Sun D, Wang R, Zhang Y. Factors associated with the risk of cardiac death in children with hypertrophic cardiomyopathy: a systematic review and meta-analysis. Heart Lung. 2022;52: 26-36. doi: https://doi.org/10.1016/j.hrtlng.2021.11.006Marston NA, Han L, Olivotto I, et al. Clinical characteristics and outcomes in childhood-onset hypertrophic cardiomyopathy. Eur Heart J. 2021;42(20):1988-1996. doi: https://doi.org/10.1093/eurheartj/ehab14Marston NA, Han L, Olivotto I, et al. Clinical characteristics and outcomes in childhood-onset hypertrophic cardiomyopathy. Eur Heart J. 2021;42(20):1988-1996. doi: https://doi.org/10.1093/eurheartj/ehab14Norrish G, Qu C, Field E, et al External validation of the HCM Risk-Kids model for predicting sudden cardiac death in childhood hypertrophic cardiomyopathy. Eur J Prev Cardiol. 2022;29(4): 678-686. doi: https://doi.org/10.1093/eurjpc/zwab181Norrish G, Qu C, Field E, et al External validation of the HCM Risk-Kids model for predicting sudden cardiac death in childhood hypertrophic cardiomyopathy. Eur J Prev Cardiol. 2022;29(4): 678-686. doi: https://doi.org/10.1093/eurjpc/zwab181Joseph A, Hernandez NB, Davies R, Tan W. Managing Myocardial Bridge and Right Ventricular Outflow Tract Obstruction in an Adolescent With Hypertrophic Cardiomyopathy. World J Pediatr Congenit Heart Surg. 2023;14(4):530-532. doi: https://doi.org/10.1177/21501351231166661Joseph A, Hernandez NB, Davies R, Tan W. Managing Myocardial Bridge and Right Ventricular Outflow Tract Obstruction in an Adolescent With Hypertrophic Cardiomyopathy. World J Pediatr Congenit Heart Surg. 2023;14(4):530-532. doi: https://doi.org/10.1177/21501351231166661Yildiz O, Altin FH, Tosun O, et al. Myocardial bridging in a child with hypertrophic obstructive cardiomyopathy. World J Pediatr Congenit Heart Surg. 2014;5(4):611-614. doi: https://doi.org/10.1177/2150135114536901Yildiz O, Altin FH, Tosun O, et al. Myocardial bridging in a child with hypertrophic obstructive cardiomyopathy. World J Pediatr Congenit Heart Surg. 2014;5(4):611-614. doi: https://doi.org/10.1177/2150135114536901Mohiddin SA, Begley D, Shih J, Fananapazir L. Myocardial bridging does not predict sudden death in children with hypertrophic cardiomyopathy but is associated with more severe cardiac disease. J Am Coll Cardiol. 2000;36(7):2270-2278. doi: https://doi.org/10.1016/s0735-1097(00)00987-6Mohiddin SA, Begley D, Shih J, Fananapazir L. Myocardial bridging does not predict sudden death in children with hypertrophic cardiomyopathy but is associated with more severe cardiac disease. J Am Coll Cardiol. 2000;36(7):2270-2278. doi: https://doi.org/10.1016/s0735-1097(00)00987-6Лысенко А.В., Салагаев Г.И., Леднев П.В., Белов Ю.В. Хирургическое лечение обструктивной гипертрофической кардиомиопатии в сочетании с миокардиальным мостиком передней нисходящей артерии // Хирургия. Журнал им. Н.И. Пирогова. — 2022. — № 1. — С. 81-83. — doi: https://doi.org/10.17116/hirurgia201911152Lysenko AV, Salagaev GI, Lednev PV, Belov YuV. Surgical treatment of obstructive hypertrophic cardiomyopathy combined with muscle bridging of the left anterior descending artery. Pirogov Russian Journal of Surgery. 2022;(1):81-83. (In Russ). doi: https://doi.org/10.17116/hirurgia201911152Kurath-Koller S, Sallmon H, Scherr D, et al. Wearable cardioverter-defibrillator as bridging to ICD in pediatric hypertrophic cardiomyopathy with myocardial bridging — a case report. BMC Pediatr. 2020;20(1):207. doi: https://doi.org/10.1186/s12887-020-02113-wKurath-Koller S, Sallmon H, Scherr D, et al. Wearable cardioverter-defibrillator as bridging to ICD in pediatric hypertrophic cardiomyopathy with myocardial bridging — a case report. BMC Pediatr. 2020;20(1):207. doi: https://doi.org/10.1186/s12887-020-02113-wColeman JA, Ashkir Z, Raman B, Bueno-Orovio A. Mechanisms and prognostic impact of myocardial ischaemia in hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 2023;39(10): 1979-1996. doi: https://doi.org/10.1007/s10554-023-02894-yColeman JA, Ashkir Z, Raman B, Bueno-Orovio A. Mechanisms and prognostic impact of myocardial ischaemia in hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 2023;39(10): 1979-1996. doi: https://doi.org/10.1007/s10554-023-02894-yÖstman-Smith I. What Aspects of Phenotype Determine Risk for Sudden Cardiac Death in Pediatric Hypertrophic Cardiomyopathy? J Cardiovasc Dev Dis. 2022;9(5):124. doi: https://doi.org/10.3390/jcdd9050124Östman-Smith I. What Aspects of Phenotype Determine Risk for Sudden Cardiac Death in Pediatric Hypertrophic Cardiomyopathy? J Cardiovasc Dev Dis. 2022;9(5):124. doi: https://doi.org/10.3390/jcdd9050124

The authors declare that there are no conflicts of interest present.