Medical therapies for hypertrophic cardiomyopathy: Current state of the art

Milind Y Desai; Anjali Owens; Andrew Wang

doi:10.1016/j.pcad.2023.08.006

Medical therapies for hypertrophic cardiomyopathy: Current state of the art

Prog Cardiovasc Dis. 2023 Sep-Oct:80:32-37. doi: 10.1016/j.pcad.2023.08.006. Epub 2023 Aug 22.

Authors

Milind Y Desai¹, Anjali Owens², Andrew Wang²

Affiliations

¹ From the Hypertrophic Cardiomyopathy Center, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States of America; Center for Inherited Cardiovascular Disease, Department of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA and Division of Cardiology, Department of Medicine, Duke University, Durham, NC, United States of America. Electronic address: desaim2@ccf.org.
² From the Hypertrophic Cardiomyopathy Center, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States of America; Center for Inherited Cardiovascular Disease, Department of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA and Division of Cardiology, Department of Medicine, Duke University, Durham, NC, United States of America.

PMID: 37619712
DOI: 10.1016/j.pcad.2023.08.006

Abstract

Hypertrophic cardiomyopathy (HCM) is predominantly an autosomal dominant genetic heart disease with an estimated prevalence of 1 in 200 to 1 in 500 in the general population. Clinical manifestations of HCM vary from asymptomatic state to mild functional intolerance to advanced heart failure, angina, and sudden cardiac death (SCD). Current management options for symptomatic HCM include lifestyle modifications, pharmacotherapy for symptom control and arrhythmia management, SCD risk stratification with or without defibrillator implantation, septal reduction therapy and, in some cases, heart transplantation. Until recently, none of the pharmacotherapies for management of HCM had been studied in multicenter randomized controlled trials. Mavacamten, a cardiac myosin inhibitor, is the first drug studied in this fashion and the first-in-class Food and Drug Administration approved medication that specifically targets the pathophysiology of HCM. We will review the currently available medical treatments for HCM and assess future directions.

Keywords: Cardiac myosin inhibitor; Hypertrophic cardiomyopathy; Medical therapies.

Publication types

Review

MeSH terms

Cardiomyopathy, Hypertrophic* / diagnosis
Cardiomyopathy, Hypertrophic* / drug therapy
Death, Sudden, Cardiac / epidemiology
Death, Sudden, Cardiac / etiology
Death, Sudden, Cardiac / prevention & control
Heart Failure*
Heart Transplantation*
Humans
Multicenter Studies as Topic