Functions and mechanism of action of Mavakatai/Maifantuo capsules

Mavacamten (mavacamten) is an innovative oral small molecule drug developed for hypertrophic cardiomyopathy (HCM) . Its core value lies in directly acting on the myocardial contractile device itself, rather than regulating hemodynamics in the traditional sense. From a mechanism level, Mavaceta is classified as a "selective cardiac myosin inhibitor". This positioning gives it obvious differentiation characteristics in the cardiovascular drug system.

In hypertrophic cardiomyopathy, especially obstructive hypertrophic cardiomyopathy (oHCM), excessive and sustained cross-bridges are formed between myosin and actin in myocardial cells, leading to abnormal increase in myocardial contractility, thickening of the ventricular wall, and aggravation of left ventricular outflow tract obstruction. This "excessive contraction state" not only affects ejection, but also causes a decrease in diastolic compliance, which is an important pathological basis for patients to experience decreased activity tolerance, chest tightness, shortness of breath, palpitations and even syncope. The mechanism of action of Mavaceta is to reversibly inhibit cardiac myosin ATPase activity and reduce the number of myosin heads that can participate in contraction, thereby reducing abnormally enhanced myocardial contractility.

From a functional perspective, Mavakatai does not simply "weaken heart function", but helps myocardial contraction return to a balance range closer to the physiological state. Overseas studies generally believe that the drug reduces the pressure gradient of the left ventricular outflow tract, making the heart pumping process more coordinated, while improving diastolic function, helping to reduce the symptom burden caused by myocardial hypertrophy and stiffness. This strategy of "regulating myofilament dynamics from the source" is considered to be a precise intervention in the pathogenesis of hypertrophic cardiomyopathy.

In terms of clinical experience, Mavakatai is administered orally in capsule form, with a clear mechanism of action and a single target of action. Compared with traditional β-blockers or calcium channel blockers, they do not rely on changes in heart rate or vascular tone to work, so they show better tolerability and symptom improvement potential in some patients.

Reference materials:https://bnf.nice.org.uk/drugs/mavacamten/