ArticleEuropean heart journal. Digital health2026
Development of a smartphone-based app to support the differential diagnosis in patients with primary left ventricular hypertrophy.
Article in European heart journal. Digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aims: Patients with primary left ventricular hypertrophy (LVH) often experience a diagnostic delay of several years, largely related to fragmented knowledge among different specialties and the rarity of the conditions. We developed and validated a digital support tool to guide the physician in the differential diagnostic process of patients presenting with primary LVH. Methods and results: A total of 818 patients with definitive diagnosis of sarcomeric hypertrophic cardiomyopathy (HCM) or one of its phenocopies [479 (62%) males, 48 ± 24 years] were included. Pre-specified disease-specific red flags (RFs) were categorized into five domains: family history, signs/symptoms, electrocardiography, echocardiographic, and laboratory. Each patient's characteristics were inserted by two independent and blind investigators into the app. The diagnostic outcome, based on the presence/absence of RF, was categorized as follows: (i) most likely diagnosis, (ii) possible diagnosis, and (iii) less likely diagnosis. A total of 2979 RFs were identified and non-sarcomeric phenocopies exhibited a higher RF burden than sarcomeric HCM (3.9 vs. 2.7 RFs per patient, Conclusion: The Thick-Heart App correctly classified 93% of cases into the most-likely diagnosis category (sensitivity 88-100%, specificity 97%). Our study underscores the potential clinical value of digital decision support tools to enable timelier identification of specific cardiomyopathies, by promoting awareness in non-reference settings.
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