{
  "abstract": "BackgroundReal-world data regarding mavacamten use in underserved and racially diverse populations remain limited, particularly for long-term therapy implementation. Structural barriers such as financial instability, fragmented healthcare access, and challenges adhering to REMS-related monitoring requirements may affect longitudinal therapy implementation.\n\nMethodsWe performed a retrospective observational study of consecutive patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) evaluated for mavacamten therapy at a tertiary HCM center in Bronx, NY, between 6/2022-10/2025. Patients were followed for up to 48 weeks after treatment initiation. Clinical characteristics, treatment interruptions, adverse events, echocardiographic and functional outcomes, and implementation barriers were assessed descriptively.\n\nResultsSeventy-two patients with symptomatic oHCM were evaluated for mavacamten; sixty-seven initiated treatment. Mean age was 66.9{+/-}15.3 years, 72% were female, and 61% identified as Black or Hispanic. Median resting left ventricular outflow tract (LVOT) gradient decreased from 51mmHg (IQR30-88) at baseline to 7mmHg (IQR5-10) at 48 weeks. Median Valsalva LVOT gradient decreased from 74mmHg (IQR50-104) to 20mmHg (IQR10-29). At final follow-up, 80% of patients improved by [≥]1 NYHA functional class. LVEF declined below 50% in five patients and recovered in all cases. Approximately one-quarter experienced treatment interruption or discontinuation, nearly half related to insurance instability, non-adherence, and REMS-related monitoring barriers.\n\nConclusionsMavacamten demonstrated efficacy and safety outcomes comparable to those reported in clinical trials and prior registries in this predominantly underserved minority urban cohort. However, structural and healthcare-access barriers substantially affected long-term treatment implementation. These findings highlight the need to address healthcare-system barriers to ensure equitable implementation of contemporary HCM therapies.",
  "abstract_shown": true,
  "affiliations": [
    "Morristown Medical Center"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "J. Bock"
    },
    {
      "name": "S. Murthy"
    },
    {
      "name": "A. L. Schenone"
    },
    {
      "affs": [
        0
      ],
      "name": "A. Weissler-Snir"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/abzm9tyx6qfvp.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.29.26364363",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.29.26364363v1.full",
  "id": "abzm9tyx6qfvp",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.29.26364363v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ],
    [
      "openalex",
      "2705|Cardiomyopathy and Myosin Studies"
    ]
  ],
  "openalex": "W7215071943",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.29.26364363v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/abzm9tyx6qfvp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:51Z",
      "native_id": "10.64898/2026.09.29.26364363",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.29.26364363v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Real-World Implementation and Clinical Outcomes of Mavacamten in an Underserved Urban Cohort With Obstructive Hypertrophic Cardiomyopathy",
  "title_text": "Real-World Implementation and Clinical Outcomes of Mavacamten in an Underserved Urban Cohort With Obstructive Hypertrophic Cardiomyopathy",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:51Z",
  "url": "https://research.draconitic.com/paper/abzm9tyx6qfvp",
  "venue": "medRxiv",
  "versions": []
}