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Updated: Aug 23, 2025

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Myosin Inhibition and Left Ventricular Diastolic Function in Patients With Obstructive Hypertrophic Cardiomyopathy

Paul C Cremer1,2, Jeffrey B Geske3, Anjali Owens4

  • 1Department of Cardiovascular Medicine (P.C.C., W.A.J., S.C.H., Q.W., K.W., S.E.N., M.Y.D.), Cleveland Clinic, OH.

Circulation. Cardiovascular Imaging
|November 6, 2022
PubMed

Insights

Mavacamten significantly improved diastolic function in patients with obstructive hypertrophic cardiomyopathy. This cardiac myosin inhibitor reduced diastolic dysfunction and correlated with enhanced clinical outcomes.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) is a condition affecting heart muscle function.
  • Mavacamten is a cardiac myosin inhibitor evaluated in the VALOR-HCM study.
  • This substudy focused on mavacamten's impact on diastolic function in HCM patients.

Purpose of the Study:

  • To assess the effect of mavacamten on diastolic function in symptomatic obstructive HCM patients.
  • To evaluate changes in diastolic function parameters and the proportion of patients with improved diastolic function grade.
  • To explore correlations between diastolic function improvements and clinical/biomarker outcomes.

Main Methods:

  • Randomized, placebo-controlled trial (VALOR-HCM substudy).
  • Patients with obstructive HCM received mavacamten or placebo for 16 weeks.
  • Echocardiograms assessed diastolic function parameters (e.g., E/e' ratio, left atrial volume).

Main Results:

  • Mavacamten treatment led to a higher proportion of patients with improved diastolic function grade (29.4% vs. 12.8%).
  • Significant reductions in E/e' ratio and indexed left atrial volumes were observed with mavacamten.
  • Improvements in diastolic function correlated with enhanced New York Heart Association class, quality of life, and cardiac biomarkers.

Conclusions:

  • Mavacamten effectively improves diastolic function in obstructive HCM patients.
  • The observed diastolic improvements are linked to better clinical and biomarker results.
  • Mavacamten represents a promising therapeutic option for managing diastolic dysfunction in HCM.
Abstract

Keywords:
Mavacamtendiastolic heart failurehypertrophic obstructive cardiomyopathyplacebo

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