Effect of CMIs on Myocardial Mechanics in oHCM
Research type
Research Study
Full title
A Multi-Centre Longitudinal Study Investigating the Effect of Cardiac Myosin Inhibitors on Myocardial Mechanics using Echocardiography in Patients with Obstructive Hypertrophic Cardiomyopathy
IRAS ID
352960
Contact name
Emily King
Contact email
Sponsor organisation
Somerset NHS Foundation Trust
Duration of Study in the UK
1 years, 2 months, 2 days
Research summary
Hypertrophic cardiomyopathy (HCM) is an inherited heart condition that affects around 1 in 500 people. In obstructive HCM (oHCM), the heart muscle becomes thickened and obstructs the flow of blood leaving the heart. This can cause symptoms such as breathlessness, chest pain, dizziness, or fainting, and may lead to heart failure or abnormal heart rhythms.
A new group of medicines, called cardiac myosin inhibitors (CMIs), has been developed to treat oHCM. These medicines, including mavacamten and aficamten, work by directly reducing the heart’s excessive muscle contraction. Clinical trials have shown that they can relieve obstruction, improve symptoms, and help patients exercise more easily. However, in a small number of people, CMIs can cause the pumping function of the heart (measured as the left ventricular ejection fraction, LVEF) to drop below normal. For this reason, people taking these medicines require regular heart ultrasound scans (echocardiograms) to monitor safety.
At present, echocardiograms mainly use traditional measures such as LVEF and global strain, which may not fully reflect the improvements seen with treatment. Newer measures, such as myocardial work (MW) and left ventricular ejection time (LVET), may give a better understanding of how efficiently the heart is working and how it responds to treatment.
This study will involve two parts. First, we will test how accurate current non-invasive methods are for estimating heart pressures, which are needed to calculate myocardial work. Second, we will follow patients with oHCM treated with CMIs for 18 months, measuring MW and LVET to see how they change over time.
By improving how we monitor treatment, this research could help doctors understand the full benefits of CMIs and guide safer, more effective care for people with oHCM.
REC name
East of England - Cambridge East Research Ethics Committee
REC reference
26/EE/0101
Date of REC Opinion
21 Apr 2026
REC opinion
Further Information Favourable Opinion