Highlights
Patients with obstructive hypertrophic cardiomyopathy (oHCM) demonstrate chronic activation of the Anrep response—a compensatory mechanism characterized by elevated afterload, hypercontractility, and increased myocardial workload. This study demonstrates that mavacamten, a cardiac myosin inhibitor, achieves hemodynamic corrections comparable to alcohol septal ablation through identical reversal of this maladaptive state. Both treatment approaches reduced afterload and contractility, shortened systolic ejection time, and decreased myocardial energetic demands while preserving stroke volume. The findings establish the Anrep response as a central therapeutic target in oHCM management.
