Important insights into the molecular basis of hypertrophic cardiomyopathy and 
related diseases have been gained by studying families with inherited cardiac 
hypertrophy. Integrated clinical and genetic investigations have demonstrated 
that different genetic defects can give rise to the common phenotype of cardiac 
hypertrophy. Diverse pathways have been identified, implicating perturbations in 
force generation, force transmission, intracellular calcium homeostasis, 
myocardial energetics, and cardiac metabolism in causing disease. Although not 
fully elucidated, the fundamental mechanisms linking gene mutations to clinical 
disease are being characterized. Further advances will allow a better 
understanding of pathogenesis, diagnosis, and treatment, not just of relatively 
rare inherited cardiomyopathies, but potentially also of relevance to more 
common acquired forms of hypertrophic remodeling.