OBJECTIVES: Obstructive hypertrophic cardiomyopathy (HCM) presents as an often-genetic disorder with few effective treatment options available, with standard of care focusing on symptom management. This study aims to investigate patient characteristics, treatment patterns and healthcare resource utilisation (HCRU) of obstructive HCM patients by New York Heart Association (NYHA) class in China.

METHODS: A two-stage survey was conducted in two sequential phases, comprising 5 in-depth interviews and 30 online questionnaires with cardiologists. Feedbacks from in-depth interviews were used to inform the online questionnaire. Descriptive statistics were conducted to summarise results.

RESULTS: 35 cardiologists from 29 hospitals, managing over 3,000 obstructive HCM patients participated in the survey. They reported the proportion of obstructive HCM among HCM cases was 17.61%, estimating the prevalence of obstructive HCM was 0.014% and 10,000 to 20,000 diagnosed obstructive sub-type cases on NYHA II-III. Among these patients, beta-blocker (BB) / calcium channel blocker (CCB) monotherapy (without prior septal reduction therapy [SRT]) was most prevalent (52.57%) followed by BB/CCB monotherapy (with prior SRT) (28.21%) and BB+CCB combination (19.21%). The proportion of patients undertaking SRT if eligible ranged from 16.37% for NYHA I to 39.26% for NYHA IV despite risks such as additional SRT, serious adverse events, and mortality. In cases of NYHA status deterioration, annual cost for HCRU without HCM medications sharply increased, totaling ¥14,123, ¥56,078, ¥112,505 and ¥180,722 for NYHA I-IV, respectively. Cardiologists were also probed around introduction of mavacamten, a newly introduced cardiac myosin inhibitor in China. Considering that mavacamten can preserve cardiac function and reverse heart structure, 88.6% recommended continuation of mavacamten treatment for patients who improved to NYHA I and maintained that status.

CONCLUSIONS: Obstructive HCM patients experienced a considerable disease burden when disease progresses. New treatments that mitigate risk of deterioration in NYHA status have the potential to improve outcomes and reduce HCRU.