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Effect of mavacamten on left ventricular diastolic function and left atrial remodelling in obstructive hypertrophic

Nicolas Cohen1, Claire Lucas1, Chiara Idini2

  • 1Department of Cardiology, CHU La Timone, AP-HM, Aix-Marseille University, 13005 Marseille, France.

Archives of Cardiovascular Diseases
|February 13, 2026
PubMed

Insights

Mavacamten improved symptoms and diastolic function in obstructive hypertrophic cardiomyopathy (HCM) patients. However, it led to decreased atrial strain, suggesting potential long-term impacts on atrial mechanics requiring further investigation.

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Diagnostics

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) causes disabling symptoms due to left ventricular outflow tract (LVOT) obstruction.
  • Mavacamten, a cardiac myosin inhibitor, effectively treats obstructive HCM symptoms and obstruction.
  • While mavacamten's effects on diastolic indices are known, its impact on left atrial strain is less understood.

Purpose of the Study:

  • To evaluate mavacamten's impact on diastolic function in obstructive HCM patients.
  • To assess changes in left atrial remodeling and ventricular filling pressures with mavacamten treatment.
  • To analyze the effects of mavacamten on key echocardiographic and clinical parameters.

Main Methods:

  • Prospective, single-center study of 55 symptomatic obstructive HCM patients.
  • Individualized mavacamten titration assessed over a mean of 5 months.
  • Collected echocardiographic (LAESV, E/E', E/A, PALS, PACS), clinical (NYHA class), and biomarker (NT-proBNP) data at baseline and after stabilization.

Main Results:

  • Significant improvements observed in NYHA class (2.5 to 1.4) and NT-proBNP levels (1431 to 158 pg/mL).
  • LVOT gradients markedly reduced at rest and post-Valsalva (P<0.001).
  • Indexed LAESV and E/E' decreased (P<0.001), while PALS and PACS showed a decline (P=0.003 and P=0.002, respectively).

Conclusions:

  • Mavacamten initiation improves diastolic parameters, reduces left atrial volume, and enhances clinical/hemodynamic measures in obstructive HCM.
  • Decreased atrial strain parameters may indicate persistent or delayed atrial mechanical dysfunction.
  • Further controlled studies are needed to elucidate long-term effects on atrial remodeling.
Abstract

Keywords:
Diastolic functionEchocardiographyHypertrophic cardiomyopathyLeft atrial remodellingMavacamten

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