Cellular and Molecular Mechanisms of Heart Failure and Sudden Cardiac Death in Hypertrophic Cardiomyopathy and Methods Used for Their Pathogenetic Correction

<b>Background/Objectives:</b> This paper provides a review of the literature data concerning the cellular and molecular mechanisms of heart failure and sudden cardiac death in hypertrophic cardiomyopathy (HCM), and explores approaches used for their pathogenetic correction. <b>Methods</b>: This study highlights genetically determined targets of primary damage to the cardiomyocyte ultra-structure-the actomyosin complex of sarcomeres and mitochondria. <b>Results/Conclusions</b>: Damage to these structures leads to heart failure and an increased risk of sudden cardiac death, manifesting against a background of phenotypic features such as cardiac remodeling, asymmetric hypertrophy, left ventricular outflow tract obstruction, myofiber disarray, and atrial fibrillation. Both invasive and non-invasive approaches for the pathogenetic management of these fatal complications are characterized.