Predictors of Left Ventricular Systolic Dysfunction during Treatment with Mavacamten for Obstructive Hypertrophic Cardiomyopathy

The cardiac myosin inhibitor mavacamten is used to alleviate symptoms in obstructive hypertrophic cardiomyopathy (oHCM).1, 2 However, it can cause left ventricular systolic dysfunction (LVSD), which occurred in 8.7% of patients in EXPLORER-HCM and 13.8% in VALOR-HCM,3, 4 and less frequently in clinical cohorts.5 Given differences in baseline demographics, we hypothesized that certain features would be associated with LVSD. Accordingly, we examined predictors of LVSD in a single-center cohort of symptomatic adults with oHCM, left ventricular outflow tract (LVOT) gradients of ≥30 mmHg at rest or ≥50 mmHg with provocation refractory to first-line therapy, NYHA class ≥2 symptoms treated with mavacamten for ≥8 weeks who enrolled in the HCM program registry All patients signed informed consent as approved by the NYU Grossman School of Medicine institutional review board.