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aficamten Aficamten is a reversible allosteric cardiac myosin inhibitor that binds directly to the motor domain of cardiac myosin and prevents it from entering the force-producing state. Nonclinical data indicate that aficamten is selective for the cardiac isoform of myosin compared to fast skeletal myosin. Specifically, aficamten inhibited bovine cardiac myofibrillar ATPase with approximately 5-fold higher potency than rabbit fast skeletal myofibrillar ATPase. It is designed to reduce the hypercontractility in the cardiac sarcomere fundamental to the pathophysiology of HCM. The consequent reduction in cardiac contractility reduces LVOT obstruction in HCM patients.

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