Dear Colleagues,

The correct etiology of left ventricular hypertrophy (LVH) is often challenging for even the most experienced physicians. The 2020 AHA guidelines defined HCM as a disease in which morphologic expression is confined solely to the heart; it is characterized predominantly by LVH in the absence of another cardiac, systemic, or metabolic disease capable of producing the magnitude of hypertrophy evident in a given patient and for which a disease-causing sarcomere (or sarcomere-related) variant is identified, or the genetic etiology remains unresolved. However, as suggested by the 2007 ESC position paper, distinguishing primary and secondary disorders is not an easy matter, in that many of the primary LVHs can be associated with major extracardiac manifestations; additionally, the pathology in many of the diseases classified as secondary LVHs can predominantly (or exclusively) involve the heart. Hence, the first approach to LVH is done by physicians, that should orient not only biochemical and instrumental analyses but also genetic testing. Of note, the cost of excluding overall causes of LVH sine causa, before using genetics, is not feasible. In addition, genetics should be interpreted in the context of the clinical picture in a given patient. To clarify some of these steps, we have launched this Special Issue, inviting investigators to contribute with original research articles as well as review articles focusing on the understanding of clinical, and genetic approaches to LVH sine causa.

Prof. Dr. Maria Losi
Guest Editor

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