Case Report: Transient hypertension and myalgia following mavacamten therapy in a patient with hypertrophic obstructive cardiomyopathy.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2025-09-10 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1578356

Mengling Peng, Yu Fu, Cong Qin, Shanshan Zhou, Jian Sun

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Abstract

Background: Mavacamten has been demonstrated to be effective in the treatment of hypertrophic obstructive cardiomyopathy (HOCM). However, its hemodynamic impact and extracardiac effects require further characterization.

Case presentation: We report a case of a 68-year-old female diagnosed with severe HOCM who experienced transient hypertension (165/105 mmHg) and myalgia four weeks after mavacamten initiation. Despite a significant reduction in LVOT obstruction (from 64 mmHg-18 mmHg) and an increase in LVEF to 78%, the patient exhibited a transient hypertensive response that resolved spontaneously within two weeks without intervention. Myalgia was present without corresponding elevations in serum creatine kinase.

Conclusions: This case highlights a previously unrecognized transient hypertensive phase associated with myosin inhibition, potentially related to ventriculo-arterial decoupling and peripheral vascular adaptation. Additionally, the dissociation between myalgia and CK elevation suggests alternative skeletal muscle involvement mechanisms. Close blood pressure monitoring and further investigation into the extracardiac effects of mavacamten are warranted.

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病例报告：一过性高血压和肌痛后治疗的肥厚性梗阻性心肌病患者。

背景：马伐卡坦已被证明对肥厚性梗阻性心肌病（HOCM）的治疗有效。然而，其血流动力学影响和心外作用需要进一步表征。病例介绍：我们报告了一例68岁的女性诊断为严重HOCM，她在服用马夫卡坦4周后出现短暂性高血压（165/105 mmHg）和肌痛。尽管LVOT阻塞明显减少（从64 mmHg-18 mmHg）， LVEF增加到78%，但患者表现出一过性高血压反应，在没有干预的情况下在两周内自发消退。肌痛存在，血清肌酸激酶没有相应的升高。结论：该病例强调了先前未被发现的与肌球蛋白抑制相关的短暂性高血压期，可能与心室-动脉解耦和周围血管适应有关。此外，肌痛和CK升高之间的分离提示骨骼肌受累的其他机制。密切的血压监测和进一步研究马伐卡坦的心外作用是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.