Related Experiment Video

Updated: Sep 17, 2025

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
07:42

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

Published on: May 19, 2020

7.1K

Anterior mitral valve leaflet length and response to mavacamten in obstructive hypertrophic cardiomyopathy

Danish Saleh1, Ellis Y Kim1, Kifah Hussain1

  • 1Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.

European Heart Journal. Imaging Methods and Practice
|July 3, 2025
PubMed

Insights

Shorter anterior mitral valve leaflet length in patients with obstructive hypertrophic cardiomyopathy (HCM) is linked to a lower effective dose and faster response to mavacamten, a myosin inhibitor. This finding may help optimize treatment for HCM.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biomedical Imaging

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) involves left-ventricular outflow tract (LVOT) obstruction, often due to septal hypertrophy and mitral valve abnormalities.
  • Mavacamten, a novel myosin inhibitor, effectively reduces LVOT gradient and improves symptoms in obstructive HCM patients.

Purpose of the Study:

  • To investigate the association between anterior mitral valve leaflet (AMVL) length and patient response to mavacamten therapy in obstructive HCM.
  • To determine if AMVL length can predict effective mavacamten dosage and speed of therapeutic response.

Main Methods:

  • Cardiac structural measurements were obtained using magnetic resonance imaging and echocardiography in 33 obstructive HCM patients treated with mavacamten.
  • Endpoints included effective mavacamten dose (to achieve Valsalva LVOT gradient <30 mmHg) and rapid response (gradient <20 mmHg within 8 weeks).

Main Results:

  • Patients requiring a 5 mg effective dose had significantly shorter AMVL length compared to those needing 10 mg or 15 mg (P < 0.001).
  • Adjusted analysis confirmed shorter AMVL length was associated with the 5 mg dose (P = 0.003).
  • Rapid responders (<8 weeks) exhibited shorter AMVL length than non-rapid responders (P = 0.006).

Conclusions:

  • Shorter anterior mitral valve leaflet length is significantly associated with a lower effective dose and rapid treatment response to mavacamten in obstructive HCM.
  • AMVL length may serve as a predictive biomarker for optimizing myosin inhibitor dosing in obstructive HCM, warranting further investigation in larger cohorts.
Abstract

Keywords:
anterior mitral valve leaflethypertrophic cardiomyopathyleft-ventricular outflow tractmavacamtenmyosin inhibitorsobstructive hypertrophic cardiomyopathy

More Related Videos

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

4.0K
Comprehensive Echocardiographic Assessment of Right Ventricle Function in a Rat Model of Pulmonary Arterial Hypertension07:38

Comprehensive Echocardiographic Assessment of Right Ventricle Function in a Rat Model of Pulmonary Arterial Hypertension

Published on: January 20, 2023

3.9K

Related Concept Videos

Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
49
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
44
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
45
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
61
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
39
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
34