Expanding the Role of Myosin Inhibition in Hypertrophic Cardiomyopathy — A Tale of Two Conditions

Hypertrophic cardiomyopathy (HCM) is a common, often inherited, and complex cardiac disease that can result in a high symptom burden. The principles of HCM management include familial cascade screening, implantation of a cardioverter–defibrillator to mitigate the risk of sudden cardiac death in high-risk patients, and treatment of burdensome symptoms. Current HCM treatment guidelines dichotomize symptom management on the basis of the presence or absence of a left ventricular outflow tract obstruction.1,2 For patients with such an obstruction (known as obstructive HCM), traditional first-line pharmacologic agents have included beta-blockers or nondihydropyridine calcium-channel blockers. Historically, patients with obstructive HCM and refractory symptoms . . .