To assess the effects of mavacamten on diastolic function and cardiac remodeling in patients with symptomatic obstructive hypertrophic cardiomyopathy.
Approach:
Study Design: Interim analysis of 465 patients treated with mavacamten over 18 months, part of the ongoing MARVEL-HCM study.
Assessment Methods: Echocardiographic markers including medial and lateral e′ velocities, average E/e′ ratio, left ventricular wall thickness (LVWT), left ventricular mass index (LVMI), and left atrial volume index (LAVI) were measured at baseline and at 18 months.
Key Findings:
Statistically significant increase in medial e′ velocity (0.05 m/s to 0.06 m/s) and lateral e′ velocity (0.07 m/s to 0.08 m/s).
Statistically significant decrease in average E/e′ ratio (17.4 to 14.2).
Statistically significant decreases in LVWT (18.5 mm to 17.6 mm), LVMI (126.3 g/m² to 117.6 g/m²), and LAVI (45.5 mL/m² to 38.4 mL/m²).
No new safety signals reported.
Interpretation:
The findings indicate improvements in diastolic function and cardiac remodeling markers in patients treated with mavacamten.
Limitations:
Retrospective, uncontrolled analysis without a comparator group.
Lack of statistical adjustment methods and missing-data handling.
No endpoint-specific counts of patients with complete 18-month echocardiographic data.
Conclusion:
The study reports longitudinal changes in treated patients but does not establish causality regarding mavacamten's effects.
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