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Background and Importance Hypertrophic obstructive cardiomyopathy (HOCM) is characterised by dynamic obstruction of the left ventricular outflow tract (LVOT), disabling symptoms, and an increased risk of cardiovascular events. Mavacamten, a selective cardiac myosin modulator, has demonstrated improvements in hemodynamic parameters, functional class, and quality of life in patients with HOCM.Aim and Objectives This study aimed to evaluate the effectiveness of mavacamten in real-world clinical practice, as well as the patients perception and degree of treatment satisfaction.Material and Methods A descriptive, observational, and retrospective study was conducted including all HOCM patients treated with mavacamten who had completed at least six months of therapy. Collected variables included age, sex, toxic habits, CYP2C19 phenotype, presence of pharmacological interactions, left ventricular ejection fraction (LVEF), resting and Valsalva LVOT gradients, dose titration, and the patient’s subjective clinical assessment obtained through pharmacist interview. Data were extracted from the electronic medical record (Diraya) and the institutional pharmacotherapeutic management software (Farmatools).Results Thirty patients were included (mean age 61.6 years; 43% women, 57% men). Toxic habits were reported in 36.7%. CYP2C19 phenotypes were intermediate in 77%, rapid in 17%, none poor, and 6% without available results. The initial dose was adjusted according to CYP2C19 phenotype: 2.5 mg for patients pending genetic testing and 5 mg for those with available results. After 6 months, final doses were 2.5 mg (14%), 5 mg (60%), 10 mg (13%), and 15 mg (13%). Pharmacological interactions were present in 50%, mainly with omeprazole. Mean LVEF decreased from 72% to 62%. The mean resting LVOT gradient decreased from 39 to 24 mmHg, and the Valsalva-induced gradient from 70 to 42 mmHg. After 6 months, 60% of patients reported subjective improvement, whereas 40% reported clinical worsening. Two patients discontinued treatment due to a drop in LVEF < 55%, and 10 reported increased dyspnoea or fatigue.Conclusion and relevance Mavacamten was associated with functional improvement and a significant reduction of LVOT obstruction in real-world HOCM patients. More than half of the patients reported treatment satisfaction and no adverse reactions. These findings support its use under close medical and pharmaceutical supervision to optimise dose titration and pharmacotherapeutic follow-up.Conflict of Interest No conflict of interest