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CK-586 is a novel, selective, oral small molecule cardiac myosin inhibitor developed for the potential treatment of heart failure with preserved ejection fraction (HFpEF), specifically in patients with hypercontractility and ventricular hypertrophy. It is designed to reduce cardiac hypercontractility by selectively inhibiting the ATPase activity of intact cardiac myosin but not subfragment-1 of myosin (S1). In preclinical models, CK-586 decreases the number of active myosin cross-bridges during cardiac contraction, thereby reducing contractile force without affecting calcium transients. The drug has shown promising safety and pharmacokinetic profiles in Phase 1 clinical trials and is currently being evaluated in a Phase 2 trial called AMBER-HFpEF[2][9][10].
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