Milind Y Desai, Andrew Gaballa, Yuichiro Okushi, Mohammed Abusafia, Shada Jadam, Katy Rutkowski, Susan Ospina, Sanaa Sultana, Maran Thamilarasan, Craig Asher, Zoran B Popovic, Bo Xu
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引用次数: 0
Abstract
Background: Mavacamten is commercially approved for use in symptomatic patients with obstructive hypertrophic cardiomyopathy. This study evaluated its real-world impact on symptoms, echocardiographic changes, and the need for septal reduction therapy in patients with obstructive hypertrophic cardiomyopathy treated at a multihospital referral center.
Methods: We included 244 patients with obstructive hypertrophic cardiomyopathy (mean age, 64 years; 57% women, 21% with atrial fibrillation, 51% New York Heart Association class III, 82% on β-blockers) treated with mavacamten for ≥3 months (171 for ≥12 months). Serial clinical and echocardiographic assessments were performed.
Results: New York Heart Association class distribution improved over time: at 3 months 21% class I, 61% class II, and 18% class III; at 12 months 36% class I, 57% class II, and 8% class III. After a mean of 1.02 years, significant improvements were observed in resting and post-Valsalva left ventricular outflow tract gradients (-31±33 and -57±46 mm Hg), interventricular septal thickness (-1.7±4 mm), left ventricular mass index (-9.5±32 g/m2), left atrial volume index (-12±13 mL/m2), E/e' (-5.5±6.4), left ventricular global longitudinal strain (1.04%±3.1%), and various left atrial and right ventricular strain measures (all P<0.05). Temporary interruption occurred in 8 patients (3.2%), and 3 (1.2%) discontinued mavacamten permanently. There were 2 noncardiac deaths, 7 heart failure admissions, 14 cases of new-onset atrial fibrillation, and 1 patient required septal reduction therapy. At the last visit, most patients were on 5 mg (49%) or 10 mg (26%) mavacamten.
Conclusions: In this real-world cohort, mavacamten treatment was associated with sustained symptomatic and echocardiographic improvements, suggesting a favorable disease-modifying impact with minimal need for septal reduction therapy.
期刊介绍:
As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice.
JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.