Heart failure & cardiomyopathies
Long-Term Favorable Cardiac Remodeling in Obstructive Hypertrophic Cardiomyopathy Patients Treated With Mavacamten for Up to 128 Weeks: Insights From the VALOR-HCM Trial
Authors' conclusion
In the VALOR-HCM trial, treatment with mavacamten resulted in sustained favorable cardiac remodeling, including improvement in LVOT gradients, cardiac volumes, cardiac hypertrophy, diastolic function, and markers of LA and LV strain from baseline through week 128, suggesting disease modification.
Study context
- Population
- Adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM) referred for septal reduction therapy (mean age 60.3 years; 50% men; 94% NYHA III/IV)
- Participants
- 112 adults
- Comparison
- Mavacamten, change from baseline to week 128
- Primary endpoint
- Long-term echocardiographic cardiac remodeling (LVOT gradients, LV and LA structure, function and strain)
- Follow-up
- 128 weeks
Methodological detailsplacebo-controlled for 16 weeks, then all on mavacamten, long-term extension to 128 weeks
- Placebo-controlled for 16 weeks, then all on mavacamten
- Long-term extension to 128 weeks
Primary result
As reported in the abstract
Mean % change from baseline, all patients · week 128
- Left ventricular outflow tract (LVOT) gradient, resting
- −61%
- LVOT gradient, post-Valsalva
- −72%
- LVOT gradient, postexercise
- −53%
- LV mass index
- −11%
- Septal E/e'
- −18%
- LV global longitudinal strain
- 4.5%
- LA volume index
- −6%
- LA conduit strain
- 16%
- LA contraction strain
- 35%
- LA reservoir strain
- 32%
Further findings
Events
| Outcome | ≥5 point KCCQ-23-CSS improvement | <5 point KCCQ-23-CSS improvement |
|---|---|---|
| LA and LV strain by KCCQ-23-CSS response (subgroup) · week 128 | 71 | 25 |
- LA and LV strain by KCCQ-23-CSS response (subgroup) — ≥5 point improvement: significant and sustained improvement
- all P < 0.05
LA and LV strain by KCCQ-23-CSS response (subgroup) · week 128
- <5 point improvement: no significant improvement in various LA and LV strain values
Original publication
Long-Term Favorable Cardiac Remodeling in Obstructive Hypertrophic Cardiomyopathy Patients Treated With Mavacamten for Up to 128 Weeks: Insights From the VALOR-HCM Trial. JACC Cardiovasc Imaging. Published 16 September 2025. doi:10.
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