Heart failure & cardiomyopathiesCohort study
Echocardiographic drag effect index and its association with response to mavacamten in obstructive hypertrophic cardiomyopathy
- multi-centre observational study
Authors' conclusion
Drag-based echocardiographic indices offered high discriminatory performance for mavacamten response. Integrating these patient-specific metrics into routine assessment provides valuable pathophysiological insights into SAM mechanisms in obstructive HCM.
Study context
- Population
- Patients with obstructive hypertrophic cardiomyopathy (HCM) treated with mavacamten33 (25.8%) were non-responders
- Participants
- 128 patients
- Exposure
- Non-responders vs Responders
- Non-respondersn = 33
Main finding
As reported in the abstract
Aortomitral angle (α)
P < 0.001
Observational data: associations, not effects.
Further findings
Mean
| Outcome | Non-responders | Responders | P value |
|---|---|---|---|
| Residual leaflet length (RL) · longer RL in non-responders | 1.1 (SD 0.2) | 0.8 (SD 0.3) | P < 0.001 |
| Drag effect index (sin(α) × RL) · higher drag effect index in non-responders | 1.0 (SD 0.2) | 0.7 (SD 0.3) | P < 0.001 |
Independent factors associated with non-response (multivariable logistic regression)
- resting left ventricular outflow tract (LVOT) gradient, α, and drag effect index identified as independent factors associated with non-response
Discrimination of non-response (receiver operating characteristic analysis)
- α AUC
- 0.787
- RL AUC
- 0.754
- drag effect index AUC
- 0.825
- drag effect index overall accuracy
- 73%
- moderate discriminative ability for α and RL; strong discriminatory ability for the drag effect index
Original publication
Echocardiographic drag effect index and its association with response to mavacamten in obstructive hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging. Published 22 June 2026. doi:10.1093/ehjci/jeag156
Summarised from the published abstract; every number is checked against it