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Trientine for hypertrophic cardiomyopathy: a phase 2 trial
John P Farrant1,2, Susanna Dodd3, Anna Rosala-Hallas4
1Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.
European Heart Journal
|July 15, 2026
Summary
Trientene dihydrochloride significantly reduced left ventricular mass in patients with hypertrophic cardiomyopathy. This trial demonstrated trientine
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy, fibrosis, and energy deficiency.
- Copper ion dysregulation in cardiomyocytes impairs mitochondrial function and promotes fibrosis in HCM.
- Trientene dihydrochloride modulates copper ions, potentially improving mitochondrial function and reducing cardiac remodeling.
Purpose of the Study:
- To evaluate the efficacy and safety of trientine dihydrochloride in patients with hypertrophic cardiomyopathy.
- To assess the impact of trientine on left ventricular mass in HCM patients.
Main Methods:
- A multicentre, placebo-controlled phase 2 trial involving adults with hypertrophic cardiomyopathy.
- Patients received either trientine dihydrochloride (400 mg twice daily) or placebo for 52 weeks.
- Left ventricular mass indexed to body surface area, measured by cardiovascular magnetic resonance, was the primary endpoint.
Main Results:
- Trientene treatment resulted in a significantly greater reduction in left ventricular mass compared to placebo (-4.4 vs -1.5 g/m2; P = .009).
- The therapeutic effect of trientine was more pronounced in patients with higher baseline left ventricular mass.
- Adverse event incidence was comparable between the trientine and placebo groups.
Conclusions:
- Trientene dihydrochloride demonstrated significant efficacy in reducing left ventricular mass in patients with hypertrophic cardiomyopathy.
- The findings suggest trientine as a potential therapeutic agent for managing cardiac remodeling in HCM.
- Further research may explore long-term outcomes and optimal use of trientine in HCM management.
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