Heart failure & cardiomyopathiesResearch article
Mavacamten Versus Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: An Echocardiography-Derived Pressure-Volume Analysis
- echocardiography-derived pressure-volume analysis
Authors' conclusion
In oHCM, chronic Anrep activation maintains cardiac output against elevated afterload at high energetic cost. Our finding that mavacamten and alcohol septal ablation produce comparable hemodynamic corrections establishes the reversal of this afterload-driven state as a central mechanistic target of therapy in oHCM.
Study context
- Population
- Patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM)patients treated with mavacamten, 29 responders analysed, separate alcohol septal ablation cohort of 13 · mavacamten Thirty-six · mavacamten responders 29 · alcohol septal ablation 13
- Participants
- Thirty-six patients
- Comparison
- mavacamten compared to the anatomic relief achieved by alcohol septal ablation
- mavacamten respondersn = 29
- alcohol septal ablationn = 13
Main finding
As reported in the abstract
Anrep-related indices and myocardial workload at baseline · baseline
- all patients showed chronic activation of the Anrep response: elevated afterload (high LVESP and Ea), hypercontractility (high Ees and low ESV 150 ), and prolonged systolic ejection time, accompanied by increased mechanical workload
Further findings
Ventricular unloading (afterload, contractility, systolic ejection time, myocardial workload, stroke volume) · 3 months
- both mavacamten responders and alcohol septal ablation responders showed comparable ventricular unloading: reductions in afterload and contractility, shortened systolic ejection time, and decreased myocardial workload, all while preserving stroke volume
Diastolic indices · 3 months
- Diastolic indices improved (increased EDV and V 15 , and decreased LVEDP)
Anrep-related indices and myocardial workload in mavacamten nonresponders · 3 months
- Anrep-related indices and myocardial workload did not change
Original publication
Mavacamten Versus Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: An Echocardiography-Derived Pressure-Volume Analysis. Circ Heart Fail. Published 13 April 2026. doi:10.1161/circheartfailure.125.013392
Summarised from the published abstract; every number is checked against it