Aficamten in Nonobstructive Hypertrophic Cardiomyopathy

Cardiac myosin inhibitors have been a welcome advance in treating obstructive hypertrophic cardiomyopathy (HCM), but to date, no evidence indicates that they help symptomatic patients with HCM without obstruction. A prior trial of the myosin inhibitor mavacamten showed no benefit in this population. In this manufacturer-funded, randomized, placebo-controlled trial, researchers tested another myosin inhibitor, aficamten, in 500 adults with symptomatic HCM (31% with New York Heart Association class 3 symptoms) and echocardiographic left ventricular outflow tract gradients <30 mm Hg at rest and <50 mm Hg with Valsalva maneuver.