Patients with oHCM treated with mavacamten reported mainly non-cardiac physical barriers to physical activity (pain 17%), with all but one meeting WHO weekly physical activity guidelines.
Cross-Sectional (n=17)
No
Patients with obstructive hypertrophic cardiomyopathy treated with mavacamten achieve high levels of physical activity, with remaining barriers being predominantly non-cardiac.
Abstract Background/Introduction More than half of the patients with hypertrophic cardiomyopathy (HCM) do not meet minimum physical activity (PA) recommendations, which might even be higher in symptomatic obstructive HCM (oHCM). Recent advances in oHCM management with the advent of cardiac myosin inhibitor (CMI) therapy to relieve left ventricular outflow tract obstruction (LVOTO) substantially improve functional capacity, which may increase PA levels. Purpose To identify perceived barriers to PA and exercise following LVOTO relief with mavacamten and study and tackle any remaining barriers to PA in future trials and daily life. Methods In this cross-sectional single-centre evaluation, consecutive patients with oHCM on a stable dose of mavacamten were included. Barriers were assessed through a structured telephone interview, rated for impact on a 1-10 scale, and converted into percentage values (sum = 100% per patient). Patients completed the Exercise Self-Efficacy Scale (ESES), EQ-5D-5L and International Physical Activity Questionnaire–Short Form (IPAQ-SF); clinical data were extracted from electronic patient files. Results Between 11/2023 and 10/2025, 31 patients with oHCM started treatment with mavacamten; 17 were included (mean age 62 years, IQR 54–66; 9 men; 8 women; 35% ICD). Non-inclusion was due to unstable dosing, treatment stop, language barrier, and death of one patient. Sixteen patients were on beta-blockers, one on disopyramide. Post-CMI treatment, all patients showed NYHA class improvement and LVOT gradient 50 mmHg. The main reported barriers for PA (Figure 2A) were physical, non-cardiac, with pain (17%) being the most prominent. Other reported physical limitations were fatigue (4.5%), obesity (4%), age (4%), and deconditioning (3%). Notably, cardiac barriers such as exertional dyspnoea or chest pain were rarely reported (9%). Psychological barriers occurred in some (16%), none feared sudden cardiac death or ICD therapy, and only 3 limited their PA due to concern about worsening their HCM (5%). This concern was never assigned the highest impact score. One patient reduced PA mainly on the advice of the treating cardiologist. Environmental barriers were mainly driven by lack of time. The IPAQ-SF showed that, even after correcting for overreporting (truncated scoring method), all but one patient met the WHO weekly PA guidelines (600 Metabolic Equivalent Task minutes per week - MET-min/week). Mean truncated activity was 4085 MET-min. EQ-5D-5L VAS score indicated good patient-rated overall health (mean 74, IQR 70-80). Patients also reported high self-efficacy (mean 76.88, IQR 70-87). Conclusion Patients with oHCM who had relief of the LVOTO by CMI are generally active and rated their health favourably. Although all patients experienced moderate to major shortness of breath before treatment, this was no longer a primary barrier. Remaining barriers were mostly non-cardiac and some may reflect the effect of a previously sedentary lifestyle.Mava dose, NYHA class and LVOT evolutionFor image description, please refer to the figure legend and surrounding text. Barriers limiting PA and count / patientFor image description, please refer to the figure legend and surrounding text.
Seghers et al. (Mon,) conducted a cross-sectional in obstructive hypertrophic cardiomyopathy (n=17). mavacamten was evaluated on Perceived barriers to physical activity. Patients with oHCM treated with mavacamten reported mainly non-cardiac physical barriers to physical activity (pain 17%), with all but one meeting WHO weekly physical activity guidelines.