Mavacamten therapy led to progressive reverse remodeling in a patient with HOCM, with reduced LV mass index and normalized extracellular volume after two years.
Does mavacamten therapy improve long-term structural reverse remodeling assessed by CMR in a patient with symptomatic HOCM?
Mavacamten therapy in a patient with HOCM demonstrated continuous structural reverse remodeling on CMR over a two-year follow-up period, extending known short-term benefits.
Absolute Event Rate: 0% vs 0%
Abstract Background Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by dynamic left ventricular outflow tract (LVOT) obstruction and impaired quality of life. Mavacamten, a first-in-class myosin inhibitor, offers a novel therapeutic approach for HOCM, which improves clinical symptoms and exercise capacity while leading to reduction of LVOT gradient and favourable cardiac remodeling in echocardiography and cardiovascular magnetic resonance (CMR). However, data on CMR-derived treatment effects remain limited to short follow-up studies. Case summary A 39-year-old male with symptomatic HOCM refractory to bisoprolol and disopyramide was initiated on mavacamten therapy. Serial CMR after one and two years demonstrated progressive reverse remodeling over the follow-up period, including ongoing reduction of LV ejection fraction and LV mass index. While late gadolinium enhancement mass remained unchanged, there were divergent changes to measures of interstitial fibrosis: While native T1 relaxation times steadily decreased, extracellular volume (ECV) fraction initially increased but normalized at two-year follow-up. Discussion This case indicates that mavacamten leads to longer-term cardiac remodeling up to two years after initiation of treatment beyond early hemodynamic improvement and reduction of LVOT obstruction. These observations nurture additional studies to investigate longer-term effects on myocardial structure, function, and interstitial fibrosis.
Seuthe et al. (Sat,) reported a other. Mavacamten therapy led to progressive reverse remodeling in a patient with HOCM, with reduced LV mass index and normalized extracellular volume after two years.