Authors' names: Katie Williams, Justin Joy, Stuart Pope, Ozlem Bilen, Matthew Gold, Byron Williams III
Background/Purpose: To evaluate the real-world incidence of left ventricular ejection fraction (LVEF) decline to <50% and identify predictors associated with reduced LVEF in patients receiving mavacamten for obstructive hypertrophic cardiomyopathy at an academic medical center.
Methodology: This is a single-center, retrospective chart review of adult patients diagnosed with obstructive hypertrophic cardiomyopathy, who have received mavacamten therapy for at least 3 weeks at the Emory Heart and Vascular Clinic from May 1, 2022, to September 30, 2024. Eligible patients must have a baseline left ventricular outflow tract gradient (LVOT) >30 mmHg and available echocardiogram data at both baseline and post-treatment initiation. Patients with incomplete medical records will be excluded. A univariate logistic regression analysis was performed to identify predictors associated with EF decline.
Results: A total of 54 patients met the inclusion criteria for the IRB-approved study. Among these, five patients (9.3%) discontinued mavacamten therapy
[JJ4] . Three patients (5.6%) had an incidence of EF decline <50% during mavacamten therapy; two of them (66.7%) discontinued mavacamten. Patients that discontinued mavacamten had similar EF at baseline than those who continued mavacamten (51.2% vs. 63.6%; P=0.093). Similarly, patients that discontinued mavacamten had similar EF post mavacamten treatment than those who continued mavacamten (52.7% vs. 60.9%; P= 0.127). No factors were associated with EF decline were identified in the initial analysis.
Conclusions: The study revealed that the majority of patients did not have a EF decline <50% while on mavacamten for hypertrophic cardiomyopathy. Given the inconclusive findings, further exploratory analyses will be conducted to identify potential predictors of EF decline.
Presentation Objective: Identify key factors that may contribute to a decrease in ejection fraction in patients taking mavacamten for hypertrophic cardiomyopathy.
