{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:27:31Z","timestamp":1787236051126,"version":"build-2736575974"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder. Left ventricular outflow tract (LVOT) obstruction typically results from systolic anterior motion (SAM) of the anterior mitral leaflet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We describe a 26-year-old man with HCM in whom SAM was generated by isolated elongation of the posterior mitral leaflet, a rare mechanism with important clinical implications. He was diagnosed during childhood by a paediatric cardiologist and followed until transition to adult care. On presentation, he was in NYHA (New York Heart Association) class II with asymmetric septal hypertrophy (25\u2005mm) and posterior leaflet elongation causing LVOT obstruction. Cardiac magnetic resonance confirmed hypertrophy and late gadolinium enhancement at the site of maximal wall thickness. Genetic testing revealed a pathogenic MYH7 variant (p.Ile263Thr) and a MYH6 classified as of uncertain significance. Treatment with mavacamten 5\u2005mg led to a reduction of the LVOT gradient from 63 to 32\u2005mmHg and symptomatic improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates an unusual anatomical substrate for LVOT obstruction in HCM and emphasizes the role of multimodality imaging in diagnosis. It also highlights the therapeutic potential of myosin inhibition with mavacamten in avoiding invasive interventions in complex phenotypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag528","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:58:29Z","timestamp":1783684709000},"source":"Crossref","is-referenced-by-count":1,"title":["Isolated posterior mitral leaflet elongation as a rare mechanism of systolic anterior motion in hypertrophic cardiomyopathy: a case report of successful treatment with mavacamten"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-7028","authenticated-orcid":false,"given":"Luis Enrique","family":"Gomez","sequence":"first","affiliation":[{"name":"Inherited Heart Disease Clinic, Hospital General de Agudos \u201cDr. Juan A. Fern\u00e1ndez\u201d, Cervi\u00f1o 3356, C1425AGP \u00a0 Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2985-4790","authenticated-orcid":false,"given":"Paula In\u00e9s","family":"Buonfiglio","sequence":"additional","affiliation":[{"name":"Inherited Heart Disease Clinic, Hospital General de Agudos \u201cDr. Juan A. Fern\u00e1ndez\u201d, Cervi\u00f1o 3356, C1425AGP \u00a0 Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-2590","authenticated-orcid":false,"given":"Judith","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Hospital General de Ni\u00f1os \u201cDr. Pedro de Elizalde\u201d, Av. Montes de Oca 40, C1270AAN \u00a0 Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0726-5418","authenticated-orcid":false,"given":"Carlos David","family":"Bruque","sequence":"additional","affiliation":[{"name":"Unidad de Conocimiento Traslacional Hospitalaria Patag\u00f3nica, Hospital SAMIC El Calafate, Jorge Newbery 453, Z9405CBC El Calafate , Santa Cruz ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6177-7894","authenticated-orcid":false,"given":"Andres Nicolas","family":"Atama\u00f1uk","sequence":"additional","affiliation":[{"name":"Inherited Heart Disease Clinic, Hospital General de Agudos \u201cDr. Juan A. Fern\u00e1ndez\u201d, Cervi\u00f1o 3356, C1425AGP \u00a0 Buenos Aires ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"2026072702365341600_ytag528-B1","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1016\/j.jacc.2015.01.019","article-title":"New perspectives on the prevalence of hypertrophic cardiomyopathy","volume":"65","author":"Semsarian","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2026072702365341600_ytag528-B2","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1161\/01.CIR.92.4.785","article-title":"Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA study. Coronary artery risk development in (young) adults: echocardiographic analysis of 4111 subjects in the CARDIA study","volume":"92","author":"Maron","year":"1995","journal-title":"Circulation"},{"key":"2026072702365341600_ytag528-B3","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1161\/01.CIR.0000066323.15244.54","article-title":"Hypertrophic cardiomyopathy: distribution of disease genes, spectrum of mutations, and implications for a molecular diagnosis strategy","volume":"107","author":"Richard","year":"2003","journal-title":"Circulation"},{"key":"2026072702365341600_ytag528-B4","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":"2026072702365341600_ytag528-B5","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.ejmg.2010.07.007","article-title":"Prevalence and spectrum of mutations in a cohort of 192 unrelated patients with hypertrophic cardiomyopathy","volume":"53","author":"Millat","year":"2010","journal-title":"Eur J Med Genet"},{"key":"2026072702365341600_ytag528-B6","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1161\/CIRCGEN.120.002929","article-title":"Spatial and functional distribution of MYBPC3 pathogenic variants and clinical outcomes in patients with hypertrophic cardiomyopathy","volume":"13","author":"Helms","year":"2020","journal-title":"Circ Genom Precis Med"},{"key":"2026072702365341600_ytag528-B7","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1161\/CIRCRESAHA.121.318346","article-title":"Molecular genetic basis of hypertrophic cardiomyopathy","volume":"128","author":"Marian","year":"2021","journal-title":"Circ Res"},{"key":"2026072702365341600_ytag528-B8","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1016\/j.jacc.2016.01.071","article-title":"The mitral valve in obstructive hypertrophic cardiomyopathy: a test in context","volume":"67","author":"Sherrid","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2026072702365341600_ytag528-B9","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1038\/gim.2017.218","article-title":"Adaptation and validation of the ACMG\/AMP variant classification framework for MYH7-associated inherited cardiomyopathies: recommendations by ClinGen\u2019s inherited cardiomyopathy expert panel","volume":"20","author":"Kelly","year":"2018","journal-title":"Genet Med"},{"key":"2026072702365341600_ytag528-B10","doi-asserted-by":"crossref","first-page":"G87","DOI":"10.1530\/ERP-20-0034","article-title":"The assessment of mitral valve disease: a guideline from the British society of echocardiography","volume":"8","author":"Robinson","year":"2021","journal-title":"Echo Res Pract"},{"key":"2026072702365341600_ytag528-B11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.pcad.2006.08.001","article-title":"Pathophysiology and treatment of hypertrophic cardiomyopathy","volume":"49","author":"Sherrid","year":"2006","journal-title":"Prog Cardiovasc Dis"},{"key":"2026072702365341600_ytag528-B12","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":"2026072702365341600_ytag528-B13","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1161\/CIRCULATIONAHA.122.062534","article-title":"Dose-blinded myosin inhibition in patients with obstructive hypertrophic cardiomyopathy referred for septal reduction therapy: outcomes through 32 weeks","volume":"147","author":"Desai","year":"2023","journal-title":"Circulation"},{"key":"2026072702365341600_ytag528-B14","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","volume":"80","author":"Desai","year":"2022","journal-title":"J Am Coll Cardiol"}],"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\/ytag528\/68758012\/ytag528.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/7\/ytag528\/68758012\/ytag528.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/7\/ytag528\/68758012\/ytag528.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:37:01Z","timestamp":1785134221000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag528\/8732374"}},"subtitle":[],"editor":[{"given":"Jamal Nasir","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Joon Heng","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag528","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"ytag528"}}