Efficacy and safety of the angiotensin II receptor blocker losartan for hypertrophic cardiomyopathy: the INHERIT randomised, double-blind, placebo-controlled trial

Allele-specific differences in transcriptome, miRNome, and mitochondrial function in two hypertrophic cardiomyopathy mouse models

“…This has prompted the testing of L-type Ca 2+ channel blockers (e.g., diltiazem) (22,23), angiotensin II receptor antagonists (e.g., losartan) (24), antioxidants (e.g., N-acetylcysteine) (21,25,26), and metabolic modulators (perhexiline) (27) with success in preventing hypertrophy, fibrosis, and adverse cardiac remodeling in animal models. However, neither diltiazem (28), nor losartan (29,30), nor perhexiline (31) is able to prevent development of the cardiac phenotype in HCM patients. One possible reason for the difference in outcomes between mouse and human studies could be inclusion of patients with a variety of causal HCM mutations in clinical trials.…”

Evolving Story of Clinical Trials in Hypertrophic Cardiomyopathy

“…Sadly, in this well conducted randomized trial, ranolazine showed no effect on exercise performance, plasma pro-brain natriuretic peptide levels, diastolic left ventricular function or quality of life. This finding adds to a rather depressing lack of efficacy in other studies [4] and the premature termination of trials examining a novel late sodium current inhibitor, eleclazine [5], and the drug perhexiline [6].…”

Hypertrophic Cardiomyopathy: New Evidence Since the 2011 American Cardiology of Cardiology Foundation and American Heart Association Guideline

“…This study enrolled patients with the clinical diagnosis of HCM without the requirement of a sarcomeric protein mutation. Although the safety of this drug was shown in the patients with both obstructive and non-obstructive HCM (thus offering a safe, effective treatment of hypertension in patients with HCM), losartan therapy was not associated with LV mass regression by CMR [32]. Going forward, with the improved use and yield of genetic testing, a better understanding of relationship between a positive genotype and response to drug therapies may offer a more personalized approach in the era of precision medicine.…”