Emerging Medical Treatment for Hypertrophic Cardiomyopathy
Alessia Argirò, Mattia Zampieri, Martina Berteotti, Alberto Marchi, Luigi Tassetti, Chiara Zocchi, Luisa Iannone, Beatrice Bacchi, Francesco Cappelli, Pierluigi Stefàno, Niccolò Marchionni, Iacopo Olivotto
Abstract
Hypertrophic cardiomyopathy (HCM) is a common myocardial disease characterized by otherwise unexplained left ventricular hypertrophy. The main cause of disabling symptoms in patients with HCM is left ventricular outflow tract (LVOT) obstruction. This phenomenon is multifactorial, determined both by anatomical and functional abnormalities: myocardial hypercontractility is believed to represent one of its major determinants. The anatomical anomalies are targeted by surgical interventions, whereas attenuating hypercontractility is the objective of old and new drugs including the novel class of allosteric myosin inhibitors. This review summarizes the current treatment modalities and discusses the emerging therapeutical opportunities focusing on the recently developed cardiac myosin ATPase inhibitors Mavacamten and CK-274. Novel surgical and interventional approaches are also discussed.