Heart failure & cardiomyopathies
Serial Changes in Ventricular Strain in Symptomatic Obstructive Hypertrophic Cardiomyopathy Treated With Mavacamten: Insights From the VALOR-HCM Trial
Authors' conclusion
In VALOR-HCM, treatment with mavacamten improved LV-GLS from baseline through week 56 (with no significant worsening of LV-GLS in patients with a reduction in LV ejection fraction ≤50%), suggesting a favorable long-term impact on regional LV systolic function. Additionally, there was no detrimental impact on RV systolic function.
Study context
- Population
- Severely symptomatic obstructive hypertrophic cardiomyopathy eligible for septal reduction therapy (mean 60 years; 51% male; LVEF 68%)
- Participants
- 112 participants
- Comparison
- Mavacamten vs placebo transitioned to mavacamten at week 16
- Mavacamtenn = 56
- Placebon = 52reference
- Primary endpoint
- Serial change in LV-GLS and RV strain (RV 4-chamber and free wall); more negative is favourable
- Follow-up
- Baseline to week 56
Methodological detailsvendor-neutral strain software
- Vendor-neutral strain software
Primary result
As reported in the abstract
LV-GLS, total study sample
- LV-GLS significantly improved
- P=0.02
- Baseline mean LV-GLS
- −14.7%
- Baseline mean right ventricular (RV) 4-chamber strain
- −22.2%
- Baseline mean RV free wall strain
- −16.8%
Further findings
RV-GLS (free wall and 4-chamber) · baseline to week 56
- Free wall RV-GLS unchanged
- P = 0.62
- 4-chamber RV-GLS unchanged
- P = 0.56
Safety
Transient LVEF reduction (<50%) requiring temporary drug interruption
- Patients with transient LVEF reduction
- 12
- Permanent discontinuations among them
- 3
- Baseline LV-GLS in this subgroup (worse than total)
- −11.4%
- No significant LV-GLS worsening baseline to week 56 in this subgroup
- P = 0.64
Original publication
Serial Changes in Ventricular Strain in Symptomatic Obstructive Hypertrophic Cardiomyopathy Treated With Mavacamten: Insights From the VALOR-HCM Trial. Circ Cardiovasc Imaging. Published 2 September 2024. doi:10.
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