Seuthe, Katharina 
ORCID: 0000-0002-6346-7500, Feidakis, Athanasios ORCID: 0009-0001-9540-9401, Nies, Richard ORCID: 0000-0002-1336-6031, Brüwer, Monique ORCID: 0000-0002-0152-3407, Pennig, Lenhard ORCID: 0000-0002-6606-9313, Kaya, Kenan ORCID: 0009-0008-7625-3457, ten Freyhaus, Henrik, Baldus, Stephan ORCID: 0000-0001-8259-1737 and Pfister, Roman ORCID: 0000-0002-4358-5008
(2026).
Hemodynamic and symptomatic response in hypertrophic obstructive cardiomyopathy patients on myosin inhibitor therapy.
Frontiers in Cardiovascular Medicine, 12.
pp. 1-12.
Frontiers Media.
ISSN 2297-055X
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Abstract
[Artikel-Nr.: 1639855] Aims: To provide real-world data on the symptomatic and hemodynamic response of the myosin inhibitor mavacamten in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: Patients with HOCM up-titrated to their final mavacamten dose were included. The final dose was defined as (i) 15 mg daily (or 5 mg for poor CYP2C19 metabolizers), (ii) a dose achieving a complete hemodynamic response (LVOT gradient <30 mmHg), or (iii) a lower dose limited by adverse effects. Final evaluation was performed 12 weeks after reaching the final dose. Symptomatic response was defined as ≥1 NYHA class improvement, and incomplete hemodynamic response as residual LVOT gradient ≥30 mmHg. Results: 40 patients (56 ± 12 years, 78% male) were included. The LVOT gradient (rest: −25 ± 32 mmHg, p < 0.001, Valsalva: −73 ± 56 mmHg, p < 0.001) and NT- proBNP levels (−785 ± 1,122 ng/L, p < 0.001) significantly decreased during a mean follow up of 184 ± 83 days. 78% had a symptomatic response and 93% were complete hemodynamic responders. Patients with no improvement in NYHA class had a lower e′ lat. (9 ± 3 cm/s vs. 6 ± 2 cm/s, p = 0.034) and less often baseline therapy with beta-blockers. Patients with incomplete hemodynamic response had a significantly higher baseline septum thickness (26.3 ± 4.9 mm vs. 19.1 ± 3.7 mm, p = 0.007) and higher LV-mass index (205 ± 63 mL/m2 vs. 139 ± 31 mL/m2, p = 0.038). Absolute reduction of LVOT gradients was similar in patients with and without clinical or hemodynamic response. Conclusion: Clinical and hemodynamic response to mavacamten was high in this real-world cohort and comparable to pivotal trial results. Incomplete response might be related to more severe baseline disease, which needs further study.
| Item Type: | Article |
| Creators: | Creators Email ORCID ORCID Put Code ten Freyhaus, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED |
| URN: | urn:nbn:de:hbz:38-812226 |
| Identification Number: | 10.3389/fcvm.2025.1639855 |
| Journal or Publication Title: | Frontiers in Cardiovascular Medicine |
| Volume: | 12 |
| Page Range: | pp. 1-12 |
| Number of Pages: | 12 |
| Date: | 2 January 2026 |
| Publisher: | Frontiers Media |
| ISSN: | 2297-055X |
| Language: | English |
| Faculty: | Faculty of Medicine |
| Divisions: | Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin Faculty of Medicine > Radiologische Diagnostik > Institut und Poliklinik für Radiologische Diagnostik |
| Subjects: | Medical sciences Medicine |
| Uncontrolled Keywords: | Keywords Language hypertrophic obstructive cardiomyopathy ; myosin inhibitor ; mavacamten ; hemodynamic response ; symptomatic response English |
| ['eprint_fieldname_oa_funders' not defined]: | Publikationsfonds UzK |
| Refereed: | Yes |
| URI: | http://kups.ub.uni-koeln.de/id/eprint/81222 |
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