The Effect of the Cardiac Myosin Activator, Omecamtiv Mecarbil, on Right Ventricular Structure and Function in Chronic Systolic Heart Failure (cosmic-hf)

Background Omecamtiv mecarbil (OM) is a cardiac myotrope which selectively activates cardiac myosin and thereby increases cardiac contractility. The aim of the current study was to determine the effect of therapy with OM on right ventricular (RV) structure and function in patients with heart failure (HF). Methods In the COSMIC-HF trial, 448 patients with stable, symptomatic HF and left ventricular ejection fraction (LVEF) Results Patients were 63±11 years old with LVEF of 29.1±7.3%. OM had no effect on RV-EDA nor TAPSE (Figure). However, OM significantly improved several measures of RV function such as RV-SET, RV-ESA, RVOT-VTI together with measures of RV pulmonary arterial coupling (PASP, TAPSE/PASP ratio and RVOT-VTI/PASP ratio) (Figure). Conclusion In patients with chronic HF and reduced systolic function, 20 weeks of OM treatment was associated with improvement in several measures of RV function together with improvement in measures of RV pulmonary arterial coupling.