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Mavacamten in hypertrophic obstructive cardiomyopathy with hepato-renal comorbidities: A case report

Liping Ma1, Fengqin Li2, Sophia Dong3

  • 1Department of Cardiovascular Medicine, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, P. R. China.

Medicine
|January 7, 2026
PubMed

Insights

Mavacamten effectively treated severe hypertrophic obstructive cardiomyopathy (HOCM) outflow obstruction in a patient with multiple comorbidities. The drug improved symptoms and cardiac function without negatively impacting liver or kidney function.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Mavacamten is a novel therapeutic agent for hypertrophic obstructive cardiomyopathy (HOCM).
  • Its efficacy in patients with significant hepatic and renal impairment requires further investigation.
  • Limited safety data exists for mavacamten in individuals with coexisting liver and kidney dysfunction.

Purpose of the Study:

  • To report the safety and efficacy of mavacamten in a patient with HOCM and severe comorbidities.
  • To assess the impact of mavacamten on left ventricular outflow tract obstruction (LVOTG) and overall cardiac function.
  • To evaluate the stability of liver and kidney function during mavacamten treatment in a complex patient.

Main Methods:

  • A case study of a 68-year-old male patient with HOCM, heart failure, chronic kidney disease stage IIIb, and hepatic schistosomiasis was presented.
  • The patient was initiated on mavacamten 2.5 mg once daily for refractory severe left ventricular outflow tract obstruction (LVOTG).
  • Clinical outcomes, including New York Heart Association (NYHA) class and LVOTG, were monitored, alongside liver and kidney function parameters.

Main Results:

  • Mavacamten treatment led to a significant reduction in LVOTG from 105 to 16 mm Hg.
  • The patient's NYHA class improved from III to I-II, indicating enhanced functional capacity.
  • Hepatic and renal functions remained stable throughout the treatment period, suggesting a favorable safety profile in this context.

Conclusions:

  • Mavacamten demonstrated effectiveness in managing severe, refractory HOCM outflow obstruction in a patient with substantial multiorgan comorbidities.
  • This case underscores the potential role of mavacamten in complex HOCM cases.
  • A multidisciplinary approach is crucial for optimizing treatment outcomes in patients with HOCM and coexisting conditions.
Abstract

Keywords:
chronic kidney diseasecirrhosishypertrophic cardiomyopathyindividualize therapymavacamten

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