Exercise Performance With Aficamten vs Metoprolol in Obstructive Hypertrophic Cardiomyopathy: Insights from the MAPLE-HCM Phase 3 Randomized Trial

MedXY Editorial Team•Jun 28, 2026•Cardiology

The MAPLE-HCM trial is the first large-scale, head-to-head, phase 3 randomized trial comparing aficamten, a selective cardiac myosin inhibitor, with metoprolol, the longstanding first-line β-blocker therapy for symptomatic oHCM.
Aficamten monotherapy demonstrated superior improvements in multiple exercise parameters, including peak oxygen uptake (pVO2), submaximal ventilation efficiency (VE/VCO2 slope), anaerobic threshold, and circulatory power, compared with metoprolol.
Beyond exercise capacity, aficamten showed enhanced patient-reported health status and quality of life, significant reductions in left ventricular outflow tract gradients (LVOT-G), and favorable echocardiographic remodeling compared with metoprolol.
Safety profiles were comparable, with aficamten exhibiting modest reductions in left ventricular ejection fraction consistent with its mechanism but without adverse hemodynamic compromise.

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MedXY Editorial Team•Jun 28, 2026•Cardiology

The MAPLE-HCM trial is the first large-scale, head-to-head, phase 3 randomized trial comparing aficamten, a selective cardiac myosin inhibitor, with metoprolol, the longstanding first-line β-blocker therapy for symptomatic oHCM.
Aficamten monotherapy demonstrated superior improvements in multiple exercise parameters, including peak oxygen uptake (pVO2), submaximal ventilation efficiency (VE/VCO2 slope), anaerobic threshold, and circulatory power, compared with metoprolol.
Beyond exercise capacity, aficamten showed enhanced patient-reported health status and quality of life, significant reductions in left ventricular outflow tract gradients (LVOT-G), and favorable echocardiographic remodeling compared with metoprolol.
Safety profiles were comparable, with aficamten exhibiting modest reductions in left ventricular ejection fraction consistent with its mechanism but without adverse hemodynamic compromise.

MedXY registered readers

Create or use your MedXY account to unlock the complete article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Open language-specific specialty feeds and department pages.

Loading comments...