Effect of Aficamten on Cardiac Structure and Function in Patients With Symptomatic Nonobstructive Hypertrophic Cardiomyopathy.

Aficamten improves diastolic function and alters cardiac structure in patients with symptomatic nonobstructive hypertrophic cardiomyopathy, with significant changes observed at 36 weeks.

• Why it matters: Understanding how aficamten affects cardiac mechanics in nonobstructive hypertrophic cardiomyopathy can inform treatment strategies beyond symptom relief, addressing gaps in mechanistic insights.
• What they did: The phase 3 ACACIA-HCM trial randomized 517 symptomatic patients to receive aficamten or placebo for up to 72 weeks, assessing echocardiographic measures at 36 weeks and end of treatment with linear regression models.
• The result: Aficamten significantly decreased LV ejection fraction by 4.6% at 36 weeks, improved diastolic velocities (lateral e' and septal e'), and reduced septal E/e' and peak tricuspid regurgitation velocity, indicating enhanced diastolic function and cardiac remodeling.