{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:41:19Z","timestamp":1775018479715,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mavacamten is a cardiac-specific myosin inhibitor approved for treatment of adults with hypertrophic cardiomyopathy (HCM) symptomatic for left ventricular outflow tract (LVOT) obstruction. Since obstruction is favoured by a hyper-contractile state, it would be logical to suppose that mavacamten may also be effective in patients with mid-ventricular obstruction (MVO). We present our experience with two HCM patients having MVO effectively treated with mavacamten.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>The first case is a 55-year-old woman presenting with dyspnoea and exertional fatigue, with obstructive HCM (HOCM) and mid-ventricular peak gradient of 77\u2005mmHg associated with LVOT obstruction. The treatment with mavacamten 5\u2005mg daily determined relief of symptoms. At 16-week follow-up, there was a significant reduction of peak gradient (11\u2005mmHg in mid-ventricular tract) and a significant decrease in NT-proBNP levels from 1287 to 178\u2005ng\/L. The second case is a 55-year-old woman with predominant mid-ventricular HOCM (peak gradient 52\u2005mmHg) and past history of septal myectomy, with a residual significant gradient measured at LVOT level. The patient was started on mavacamten 5\u2005mg daily, subsequently up-titrated to 10\u2005mg. At 16-week follow-up, there was a significant reduction of peak gradient to 10\u2005mmHg and a significant decrease in NT-proBNP levels from 3910 to 718\u2005ng\/L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>These two cases highlight the efficacy of mavacamten in the reduction of MVO, suggesting that it may be a valid therapeutic option also in patients with isolated MVO, frequently more difficult to be adequately treated.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf229","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T07:03:23Z","timestamp":1746687803000},"source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of mavacamten in patients with hypertrophic cardiomyopathy and mid-ventricular obstruction: case series"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8485-3649","authenticated-orcid":false,"given":"Valeria","family":"Rella","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cardiomyopathy Unit, Istituto Auxologico Italiano, IRCCS , Ospedale San Luca, Piazzale Brescia, 20, 20149 Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisa","family":"Muraru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Integrated Cardiovascular Imaging Department, Istituto Auxologico Italiano, IRCCS , Ospedale San Luca, Piazzale Brescia, 20, 20149 Milan ,","place":["Italy"]},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Piazza dell'Ateneo Nuovo, 1, 20126 Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8739-6527","authenticated-orcid":false,"given":"Lia","family":"Crotti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiomyopathy Unit, Istituto Auxologico Italiano, IRCCS , Ospedale San Luca, Piazzale Brescia, 20, 20149 Milan ,","place":["Italy"]},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Piazza dell'Ateneo Nuovo, 1, 20126 Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"2025052601114618100_ytaf229-B1","doi-asserted-by":"crossref","first-page":"4622","DOI":"10.1093\/eurheartj\/ehad637","article-title":"Mavacamten: a first-in-class myosin inhibitor for obstructive hypertrophic cardiomyopathy","volume":"44","author":"Braunwald","year":"2023","journal-title":"Eur Heart J"},{"key":"2025052601114618100_ytaf229-B2","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0140-6736(20)31792-X","article-title":"Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"396","author":"Olivotto","year":"2020","journal-title":"Lancet"},{"key":"2025052601114618100_ytaf229-B3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jacc.2022.04.048","article-title":"Myosin inhibition in patients with obstructive hypertrophic cardiomyopathy referred for septal reduction therapy (VALOR HCM)","volume":"80","author":"Desai","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2025052601114618100_ytaf229-B4","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.1016\/j.jacc.2021.09.1381","article-title":"Effect of mavacamten on echocardiographic features in symptomatic patients with obstructive hypertrophic cardiomyopathy","volume":"78","author":"Hegde","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2025052601114618100_ytaf229-B5","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"2023 ESC Guidelines for the management of cardiomyopathies","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur Heart J"},{"key":"2025052601114618100_ytaf229-B6","doi-asserted-by":"crossref","first-page":"e1239","DOI":"10.1161\/CIR.0000000000001250","article-title":"2024 AHA\/ACC\/AMSSM\/HRS\/PACES\/SCMR. Guideline for the management of hypertrophic cardiomyopathy: a report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Ommen","year":"2024","journal-title":"Circulation"},{"key":"2025052601114618100_ytaf229-B7","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1016\/j.jacc.2011.02.033","article-title":"Clinical implications of midventricular obstruction in patients with hypertrophic cardiomyopathy","volume":"57","author":"Minami","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2025052601114618100_ytaf229-B8","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/j.1540-8191.2012.01475.x","article-title":"Transapical approach for apical myectomy and relief of midventricular obstruction in hypertrophic cardiomyopathy","volume":"27","author":"Said","year":"2012","journal-title":"J Card Surg"},{"key":"2025052601114618100_ytaf229-B9","doi-asserted-by":"crossref","first-page":"102397","DOI":"10.1016\/j.jaccas.2024.102397","article-title":"Mavacamten in right ventricular outflow tract obstruction","volume":"29","author":"Malhi","year":"2024","journal-title":"JACC Case Rep"},{"key":"2025052601114618100_ytaf229-B10","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.echo.2024.02.010","article-title":"Obstruction in hypertrophic cardiomyopathy: many faces","volume":"37","author":"Abbasi","year":"2024","journal-title":"J Am Soc Echocardiography"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf229\/63105394\/ytaf229.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/5\/ytaf229\/63105394\/ytaf229.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/5\/ytaf229\/63105394\/ytaf229.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T05:11:55Z","timestamp":1748236315000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf229\/8126791"}},"subtitle":[],"editor":[{"given":"Roman","family":"Komorovsky","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Paratz","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Aiste Monika","family":"Jakstaite","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nivholas","family":"Weight","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf229","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,5]]},"article-number":"ytaf229"}}