Heart failure & cardiomyopathiesSecondary analysis
Mavacamten-Associated Temporal Changes in Left Atrial Function in Obstructive Hypertrophic Cardiomyopathy (HCM)
- Secondary analysis of the VALOR-HCM randomised trial
Authors' conclusion
In VALOR-HCM, mavacamten resulted in an improvement in LAVI and LA strain at week 56, suggesting sustained favorable LA remodeling and improved function, except in the atrial fibrillation subgroup.
Study context
- Population
- Severely symptomatic patients with obstructive HCM eligible for septal reduction therapy (mean age 60 years; 51% male)
- Participants
- 112 patients
- Comparison
- Mavacamten vs placebo
- Mavacamtenn = 56
- Placebon = 52reference
- Primary endpoint
- Serial changes in echocardiographic LA strain (reservoir, conduit, contraction) and LA volume index
- Follow-up
- Baseline to week 56
Primary result
As reported in the abstract
Change in LA volume index and LA strain, baseline to week 56 · week 56
- LA volume index (LAVI) change
- −5.6 ± 9.7 mL/m² (P < 0.001)
- Left atrial (LA) conduit strain change
- −1.7% ± 6%
- LA contraction strain change
- −1.2% ± 4.5%
- LA reservoir strain change
- 2.8% ± 7.7%
- Significant improvement in absolute LA strain values
- P < 0.05
Further findings
Baseline LAVI and LA strain (all worse than reported normal)
- LAVI
- 41.3 ± 16.5 mL/m²
- LA conduit strain
- −11.8% ± 6.5%
- LA contraction strain
- −8.7% ± 5.0%
- LA reservoir strain
- 20.5% ± 8.7%
LA measurements, placebo · up to week 16
- No differences in LA measurements with placebo up to week 16
LA strain change in patients with history of AF (subgroup) · baseline to week 56
- LA conduit strain change
- −0.9% ± 3.8%
- LA contraction strain change
- −0.4% ± 3.4%
- LA reservoir strain change
- 1.4% ± 6.1%
- No significant improvement
- P = not significant
Original publication
Mavacamten-Associated Temporal Changes in Left Atrial Function in Obstructive HCM. JACC Cardiovasc Imaging. Published 2 September 2024. doi:10.1016/j.jcmg.2024.08.005
Summarised from the published abstract; every number is checked against it