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Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
03:45

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model

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Medical management of hypertrophic cardiomyopathy

Mohit D Gupta1, Vrinda Goel1, M P Girish1

  • 1Department of Cardiology, GB Pant Institute of Postgraduate Medical, Education and Research, New Delhi, India.

Indian Heart Journal
|June 18, 2026
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) management requires a mechanism-based approach, differing from standard heart failure care. New cardiac myosin inhibitors offer targeted therapy for obstructive and non-obstructive HCM symptoms.

Area of Science:

  • Cardiology
  • Genetics
  • Pharmacology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic myocardial disease.
  • Symptoms arise from ventricular hypertrophy, dynamic left ventricular outflow tract obstruction (LVOTO), and diastolic dysfunction.
  • HCM therapy must be mechanism-based, distinct from general heart failure management.

Purpose of the Study:

  • To provide a pragmatic clinical algorithm for contemporary Hypertrophic cardiomyopathy (HCM) management.
  • To outline mechanism-based therapeutic strategies for obstructive and non-obstructive HCM.
  • To integrate novel sarcomere-directed therapies into clinical practice.

Main Methods:

  • Review of current therapeutic strategies for Hypertrophic cardiomyopathy (HCM).
  • Discussion of pharmacologic objectives for obstructive HCM (blunt hypercontractility, lengthen diastole, reduce LVOT gradient).
  • Outline of management for non-obstructive HCM (symptom control, rate moderation, volume management, arrhythmia treatment).

Main Results:

  • Established therapies include non-vasodilating beta-blockers, non-dihydropyridine calcium-channel blockers, and disopyramide.
  • Cardiac myosin inhibitors (mavacamten, aficamten) represent a new class of sarcomere-directed treatments.
  • A pragmatic algorithm is proposed for clinical application.

Conclusions:

  • Contemporary Hypertrophic cardiomyopathy (HCM) treatment necessitates a tailored, mechanism-based strategy.
  • Cardiac myosin inhibitors offer a novel therapeutic avenue.
  • The review provides a practical guide for clinicians managing HCM patients.

Keywords:
AficamtenAtrial fibrillationBeta-blockerDisopyramideHypertrophic cardiomyopathyLVOT obstructionMavacamtenMedical management

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