Understanding Hypertrophic Cardiomyopathy: From Disease Mechanisms to Clinical Management - Episode 5
Advancing Cardiac Myosin Inhibitor Therapy: Evidence, Monitoring, and Clinical Integration
When beta blockers fall short in obstructive HCM, explore myosin inhibitors, disopyramide, or septal reduction—and see why patients breathe easier.
In this episode, Advancing Cardiac Myosin Inhibitor Therapy: Evidence, Monitoring, and Clinical Integration, the cardiovascular experts explore the following questions:
What are the best practices for monitoring patients for treatment response and adverse events once they’ve initiated a cardiac myosin inhibitor?
What are best practices when working with REMS programs with these therapies?
Aficamten was also FDA-approved in December 2025 for symptomatic obstructive hypertrophic cardiomyopathy. What was the trial design of SEQUOIA-HCM?
The panelists covered best practices for monitoring patients on cardiac myosin inhibitors, which include regular assessment of symptoms, functional capacity, and serial echocardiography to evaluate left ventricular outflow tract gradients and ejection fraction. Close monitoring is essential to detect potential adverse effects, particularly reductions in systolic function, and to guide dose adjustments or temporary treatment interruption if needed. Effective management within REMS programs requires coordinated workflows, timely documentation, and clear communication with patients to ensure compliance with safety monitoring requirements. The SEQUOIA-HCM trial evaluating aficamten was a randomized, controlled study designed to assess its impact on exercise capacity, symptom improvement, and hemodynamic measures in patients with symptomatic obstructive hypertrophic cardiomyopathy.
Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.
The next episode in this series, Differentiating Cardiac Myosin Inhibitors: Clinical Considerations and Drug Interactions, features the panelists advancing their conversation on key differences between mavacamten and aficamten, including pharmacokinetic profiles and how they may influence treatment selection in clinical practice. It also reviews potential drug–drug interactions associated with each therapy and their implications for safe and effective use.
