Clinical & Experimental Cardiology
Open Access

The Role of Cardiac Myosin Inhibitors in Preventing Heart Attacks

Sarika Aashvi^{* *}Correspondence: Sarika Aashvi, Department of Cardiac Surgery, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India, Email:

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Description

Heart attacks, also known as myocardial infarctions, are lifethreatening events that occur when blood flow to a part of the heart muscle is blocked. These events are typically caused by the formation of blood clots in the coronary arteries, which supply oxygen and nutrients to the heart. The consequences of a heart attack can be severe, often leading to damage or death of heart muscle tissue, and in some cases, they can prove fatal. Given the high prevalence of heart disease and its impact on global health, finding innovative approaches to prevent heart attacks is crucial. One such approach involves cardiac myosin inhibitors, a class of pharmaceuticals that show result in reducing the risk of heart attacks and improving overall heart health.

Cardiac myosin inhibitors are a relatively new class of drugs designed to target the cardiac myosin protein, which plays a pivotal role in the contraction of heart muscle. The inhibition of cardiac myosin has shown significant potential in reducing the workload of the heart, improving cardiac efficiency, and decreasing the risk of heart attacks. To understand the role of cardiac myosin inhibitors in preventing heart attacks, it's essential to delve into the mechanisms of heart muscle contraction, the development of these inhibitors, and their potential impact on cardiovascular health. The primary functional unit of the heart muscle is the cardiomyocyte, a specialized muscle cell that contracts in response to electrical signals. The contraction of cardiomyocytes is essential for maintaining blood circulation and, when disrupted, can lead to heart failure, arrhythmias, and ultimately, heart attacks. Cardiac myosin, a protein abundant in cardiomyocytes, is a crucial player in muscle contraction. It interacts with another protein called actin, and together, they form cross-bridges that pull on actin filaments to shorten the cardiomyocyte and cause contraction. This repetitive contraction and relaxation create the pumping action of the heart. However, this constant contracting and relaxing can place a significant amount of strain on the heart when the heart has to work more difficult such as in situations of hypertension or heart failure, raising the risk of heart attacks. Cardiac myosin inhibitors are designed to selectively target the cardiac myosin protein and reduce its contractility, without affecting skeletal muscle function.

The development of these inhibitors marks a significant breakthrough in cardiovascular pharmacology. One well-known cardiac myosin inhibitor is mavacamten, which is primarily used to treat Hypertrophic Cardiomyopathy (HCM), a genetic condition characterized by thickened heart muscle. Mavacamten works by reducing the excessive contractility of cardiac myosin, which is a hallmark of HCM. By doing so, it lessens the burden on the heart, prevents abnormal thickening, and improves overall cardiac efficiency. The primary mechanism through which cardiac myosin inhibitors help prevent heart attacks is by reducing the workload of the heart. As the heart works less strenuously, it consumes less oxygen and nutrients, decreasing the risk of ischemia (inadequate blood flow) and the formation of blood clots. When the heart doesn't have to contract as forcefully, it's less likely to experience the oxygen demand-supply mismatch that often leads to heart attacks. In addition to reducing workload, cardiac myosin inhibitors can also help improve cardiac efficiency. When the heart contracts more efficiently, it can pump blood more effectively, which, in turn, enhances the delivery of oxygen and nutrients to the body's tissues and organs. This is particularly important because compromised blood circulation can lead to various complications, including heart attacks. Atherosclerosis, the buildup of fatty deposits in the arteries, is a significant contributor to heart attacks. These deposits, known as atheromatous plaques, can rupture, causing the formation of blood clots that obstruct the coronary arteries. Cardiac myosin inhibitors may also have a role in reducing the risk of atherosclerosis.

Recent research suggests that cardiac myosin inhibitors can modulate the immune system's response to inflammation, which plays a pivotal role in the development of atherosclerotic plaques. By reducing inflammation and stabilizing these plaques, cardiac myosin inhibitors could potentially minimize the likelihood of plaque rupture and subsequent heart attacks. The use of cardiac myosin inhibitors in preventing heart attacks holds potential, but it's important to acknowledge that the field is still evolving. Many ongoing clinical trials are investigating the effectiveness and safety of these inhibitors, especially in different patient populations. One area of interest is the potential application of cardiac myosin inhibitors in patients with heart failure, particularly those with reduced ejection fraction. Heart failure patients often experience heart muscle dysfunction, and the ability of these inhibitors to reduce cardiac workload may prove valuable in preventing heart attacks in this vulnerable population. Additionally, researchers are exploring the long-term effects of cardiac myosin inhibitors and whether they can impact the natural history of heart disease. This includes assessing their potential to reduce adverse cardiovascular events, such as heart attacks, strokes, and sudden cardiac death. By targeting the cardiac myosin protein and reducing cardiac workload and improving efficiency, these inhibitors have the potential to reduce the risk of heart attacks and enhance overall heart health. Ongoing research and clinical trials will continue to focus on the safety and effectiveness of these innovative pharmaceuticals. As we gain a deeper understanding of their mechanisms and potential benefits, cardiac myosin inhibitors may become an essential tool in the fight against heart disease and the prevention of heart attacks.