Heart failure & cardiomyopathiesSecondary analysis
Effect of Aficamten Compared With Metoprolol on Echocardiographic Measures in Symptomatic Obstructive Hypertrophic Cardiomyopathy
- Secondary analysis of the MAPLE-HCM randomised trial
- exploratory
Authors' conclusion
In addition to lowering Valsalva LVOT-G and left atrial volume index, treatment with aficamten compared with metoprolol over 24 weeks led to improvement in measures of LV diastolic function, mitral valve systolic anterior motion, and mitral regurgitation. Aficamten therapy resulted in modest reduction in LVEF compared with metoprolol.
Study context
- Population
- Symptomatic obstructive hypertrophic cardiomyopathy
- Participants
- 175 participants
- Comparison
- Aficamten monotherapy vs metoprolol monotherapy
- Primary endpoint
- Echocardiographic measures of cardiac structure and function
- Follow-up
- 24 weeks
Primary result
As reported in the abstract
Aficamten vs MetoprololDifference, mm Hg (95% CI)P value
resting LVOT-G
−30(−37 to −23)
P < 0.001Valsalva LVOT-G
−35(−44 to −26)
P < 0.001Aficamten vs MetoprololDifference, mL/m2 (95% CI)P value
left atrial volume index
−7.0(−9.1 to −4.8)
P < 0.001Aficamten vs MetoprololDifference (95% CI)P value
lateral E/e'
−2.8(−4.0 to −1.6)
P < 0.001septal E/e'
−3.1(−4.5 to −1.7)
P < 0.001- Maximal wall thickness decreased
- −1.0 mm [95% CI: −1.8 to −0.2 mm]; P = 0.02
- Left ventricular ejection fraction (LVEF) decreased
- −4% [95% CI: −5% to −3%]; P < 0.001
- Absolute left ventricular (LV) global longitudinal strain decreased
- −1.2% [95% CI: −1.8% to −0.5%]; P < 0.001
- Absolute global circumferential strain decreased
- −2.5% [95% CI: −3.7% to −1.3%]; P < 0.001
Original publication
Effect of Aficamten Compared With Metoprolol on Echocardiographic Measures in Symptomatic Obstructive Hypertrophic Cardiomyopathy. J Am Coll Cardiol. Published 27 August 2025. doi:10.1016/j.jacc.2025.08.022
Summarised from the published abstract; every number is checked against it