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Review
. 2023 Apr 8:17:1097-1106.
doi: 10.2147/DDDT.S368590. eCollection 2023.

Review of Mavacamten for Obstructive Hypertrophic Cardiomyopathy and Future Directions

Tiffany Dong #  1 , Ben Alencherry #  1 , Susan Ospina  1 , Milind Y Desai  1
Affiliations
Review

Review of Mavacamten for Obstructive Hypertrophic Cardiomyopathy and Future Directions

Tiffany Dong et al. Drug Des Devel Ther. .

Abstract

Hypertrophic cardiomyopathy (HCM) is a condition with abnormal hypertrophy of the left ventricle in the absence of common causes. The most common form involves the basal septum and can lead to obstruction of the left ventricular outflow tract. Patients can experience exertional symptoms such as chest pain, dyspnea and syncope. Traditional treatment has included beta blockers and nondihydropyridine calcium channel blockers with second-line therapy being disopyramide. Recently, mavacamten, a cardiac myosin inhibitor, has demonstrated improvement in quantitative measures of obstruction and symptom relief to such a degree that patients were able to defer invasive management of the disease. This review focuses on the pharmacology of mavacamten, its clinical trial data and guidance on how to incorporate this drug into clinical practice. Furthermore, it discusses emerging therapies currently being investigated for HCM.

Keywords: EXPLORER HCM; VALOR HCM; hypertrophic cardiomyopathy; mavacamten; septal reduction therapy.

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Conflict of interest statement

Tiffany Dong and Ben Alencherry are co-first authors for this study. Dr Milind Y Desai is a consultant for Bristol Myers Squibb and Medtronic. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Molecular structure of mavacamten, 6-[[(1S)-1-phenylethyl]amino]-3-propan-2-yl-1H-pyrimidine-2,4-dione.
Figure 2
Figure 2
Authors proposed treatment cascade of obstructive HCM.
Figure 3
Figure 3
Proposed strategies for mavacamten use. Color legend: Green, contemporary; Yellow, proposed.
See this image and copyright information in PMC

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