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在阻塞性多变性心肌病中Aficamten对心脏结构和功能的影响:SEQUOIA-HCM CMR子研究

Ahmad Masri¹, Rhanderson N Cardoso², Theodore P Abraham³

¹Oregon Health and Science University, Portland, Oregon, USA.

Journal of the American College of Cardiology

|September 1, 2024

概括

在患有阻塞性缩性心肌病 (oHCM) 的患者中,Aficamten治疗显著改善了心脏重塑,减少了左心室质量和心房大小. 这些积极的变化表明,心力衰竭和中风风险的潜在降低.

科学领域:

心脏病学心脏病学
药理学药理学是指药理学的学科.
医疗成像医学成像

背景情况:

阻塞性缩性心肌病 (oHCM) 涉及左心室 (LV) 缩,外流通道阻塞和心房扩张,导致心力衰竭,心房动和中风.
作为心脏肌抑制剂的Aficamten调节收缩性以减少阻塞,并可能逆转病理重塑,可能降低心血管事件发生率.

研究的目的:

在oHCM患者中,与安慰剂相比,评估aficamten对心脏重塑的影响.
在SEQUOIA-HCM试验中使用心血管磁共振 (CMR) 与临床终点相关联心脏重塑变化.

主要方法:

第3阶段,双盲,安慰剂控制的SEQUOIA-HCM试验随机对象有症状的oHCM成年人进行24周的aficamten或安慰剂.
一个CMR子研究评估了患者子集在基线和24周的心脏重塑.
图像分析是由核心实验室以盲目的方式进行的.

主要成果:

与安慰剂相比,Aficamten治疗导致LV质量指数,最大LV壁厚度和左心房体积指数显著降低.
接受aficamten治疗的患者表现出降低了本源T1放松时间和索引细胞外体积分数.
没有观察到LV腔体积,替代纤维化或总细胞外体积的显著变化.

结论:

在oHCM患者中,24周的Aficamten治疗导致了良好的心脏重塑.
观察到LV质量,壁厚度和左心房大小的减少可能会减少未来的心血管事件.
需要进一步的随访,以确认对心力衰竭和心房的长期影响.

关键词:

一个有趣的东西.心血管磁共振是一种心血管磁共振.过度缩性心肌病变性心脏病.结果就是结果.改造改造改造改造改造改造

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