Affiliation:
1. Aurora Cardiovascular and Thoracic Services Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care Milwaukee Wisconsin USA
2. Division of Cardiovascular Medicine University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus Milwaukee Wisconsin USA
3. Academic Affairs, Cardiovascular Research Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care Milwaukee Wisconsin USA
Abstract
AbstractAimsIn clinical trials, mavacamten reduced left ventricular outflow tract obstruction (LVOTO) and improved symptoms in patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM). We aimed to share our real‐world experience with the efficacy and safety of mavacamten in this patient population.Methods and resultsThis retrospective, single‐centre study included patients with symptomatic oHCM from March 2023 to November 2023. Inclusion criteria were oHCM, age >18 years, significant LVOTO (gradient >50 mmHg at rest or with Valsalva), New York Heart Association (NYHA) class ≥II despite maximally tolerated medical therapy, and left ventricular ejection fraction (LVEF) >55%. Patients were evaluated by echocardiography, NYHA class, electrocardiography and Holter monitor on each monthly visit for 3 months. A total of 31 patients were included in this study. The mean (SD) age was 58 (16.5) years, and 14 (45%) were female. Mean provoked left ventricular outflow tract gradient (LVOTG) reduced by −49.4 mmHg (P < 0.001) at 4 weeks, −59.2 mmHg (P < 0.001) at 8 weeks, and −60.8 mmHg (P < 0.001) at 12 weeks. Twenty‐six of the 31 patients (83.8%) achieved an LVOTG ≤30 mmHg at Week 12. No major side effects were reported. Sixty‐seven percent experienced ≥2 NYHA class improvements, LVEF remained above 55% and no dose titration was made.ConclusionsOur real‐world experience aligns with established mavacamten trial outcomes. Continuous vigilance and longitudinal investigations are needed to further assess potential long‐term impacts.