NEJM This Week NEJM This Week — September 11, 2025
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Sep 10, 2025 Explore hypertrophic cardiomyopathy and rehabilitation strategies after myocardial infarction in older adults. Discover insights into the Marburg virus outbreak in Rwanda and a compelling case of a 93-year-old patient with severe aortic stenosis. Engage with the evolving debates on race correction in medicine and the push for equitable care for vulnerable populations. Uncover the impact of funding debates on health services and hear a poignant story of a high school student navigating mental health challenges amidst a backdrop of environmental anxiety.
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Myosin Inhibitor Beats Beta Blocker
- Aficamptin (cardiac myosin inhibitor) as monotherapy outperformed metoprolol for obstructive hypertrophic cardiomyopathy in peak VO2 and symptoms.
- Adverse-event rates were similar between aficamptin and metoprolol groups.
Nonobstructive HCM Still Lacks Therapies
- Mavacampin did not improve peak VO2 or symptoms versus placebo in nonobstructive hypertrophic cardiomyopathy.
- Treatment options remain poor for nonobstructive disease, highlighting a major unmet need.
HCM Is Heterogeneous With Multiple Options
- Hypertrophic cardiomyopathy is heterogeneous and often involves provokable left‑ventricular outflow obstruction.
- Effective therapies include beta blockers, calcium‑channel blockers, myosin inhibitors, ICDs, septal reduction, and transplantation.