Author + information
- Tor Biering-Sorensen,
- John Teerlink,
- G. Michael Felker,
- John McMurray,
- Fady Malik,
- Narimon Honarpour,
- Maria Laura Monsalvo,
- James Johnston and
- Scott D. Solomon
Background: Omecamtiv mecarbil (OM) is a selective cardiac myosin activator shown to improve measures of LV structure and function. We assessed the effect of OM on myocardial strain (deformation).
Methods: In the COSMIC-HF trial, 448 patients with chronic, symptomatic heart failure (HF) and left ventricular ejection fraction (LVEF) <40% were randomly assigned to oral OM [25 mg twice daily (25 mg group); or 25 mg twice daily with pharmacokinetic-guided uptitration to 50 mg twice daily (PK-titration group)] or placebo in double-blind fashion for 20 weeks. We assessed changes in measures of LV myocardial deformation (global circumferential strain (GCS) and global longitudinal strain (GLS)) in 337 patients with adequate 2D images for speckle tracking analysis. The placebo (n=113), the 25 mg group (n=119) and the PK group (n=105) were compared at baseline and week 20. Least squares means were calculated from analysis of covariance models which assessed the treatment differences vs placebo and included the stratification factor of presence of atrial fibrillation at randomization, baseline value, and the treatment group as covariates.
Results: Patients were 62.8± 10.5 years old, predominantly (83.1%) male, with baseline LVEF of 29.1± 7.4%, GLS of -9.1± 3.5% and GCS -13.4± 5.6%. Both GLS and GCS improved significantly in patients receiving OM in the 25mg group with a trend towards improvement in the PK group (Figure).
Conclusions: In patients HF and reduced systolic function, OM improved myocardial strain.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Heart Failure and Cardiomyopathies: What Next When All Else Is Failing?
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1248-244
- 2017 American College of Cardiology Foundation