Does baseline hypertension affect hemodynamic and functional responses to mavacamten in patients with symptomatic obstructive HCM?
Baseline hypertension limits complete functional recovery (achieving NYHA Class I) in obstructive HCM patients treated with mavacamten, despite effective LVOT gradient reduction.
Hypertension is common in hypertrophic cardiomyopathy (HCM) yet its impact on patients on long-term mavacamten is unknown. In this single-center observational study of 163 patients with symptomatic obstructive HCM treated with mavacamten for up to 108 weeks, hemodynamic and functional responses stratified by baseline hypertension status (60.7% hypertensive) were compared. Mavacamten produced similar reductions in resting and Valsalva LVOT gradients regardless of hypertension status. However, patients with hypertension had a significantly lower probability of achieving NYHA Class I functional status over time (interaction p=0.01). These findings suggest that hypertension-related factors beyond LVOT obstruction may limit complete functional recovery in obstructive HCM despite effective gradient reduction with mavacamten.
Reza et al. (Sun,) studied this question.