Alcohol septal ablation in patients with severe septal hypertrophy
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Alcohol septal ablation in patients with severe septal hypertrophy. / Veselka, Josef; Jensen, Morten; Liebregts, Max; Cooper, Robert M.; Januska, Jaroslav; Kashtanov, Maksim; Dabrowski, MacIej; Hansen, Peter Riis; Seggewiss, Hubert; Hansvenclova, Eva; Bundgaard, Henning; Ten Berg, Jurrien; Hilton Stables, Rodney; Faber, Lothar.
I: Heart, Bind 106, Nr. 6, 2020, s. 462-466.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Alcohol septal ablation in patients with severe septal hypertrophy
AU - Veselka, Josef
AU - Jensen, Morten
AU - Liebregts, Max
AU - Cooper, Robert M.
AU - Januska, Jaroslav
AU - Kashtanov, Maksim
AU - Dabrowski, MacIej
AU - Hansen, Peter Riis
AU - Seggewiss, Hubert
AU - Hansvenclova, Eva
AU - Bundgaard, Henning
AU - Ten Berg, Jurrien
AU - Hilton Stables, Rodney
AU - Faber, Lothar
PY - 2020
Y1 - 2020
N2 - Objective: The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement. Methods: We compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres. Results: A total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all). Conclusions: The short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.
AB - Objective: The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement. Methods: We compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres. Results: A total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all). Conclusions: The short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.
KW - alcohol septal ablation
KW - hypertrophic cardiomyopathy
KW - outflow gradient
KW - prognosis
KW - survival
U2 - 10.1136/heartjnl-2019-315422
DO - 10.1136/heartjnl-2019-315422
M3 - Journal article
C2 - 31471463
AN - SCOPUS:85071746893
VL - 106
SP - 462
EP - 466
JO - Heart
JF - Heart
SN - 1355-6037
IS - 6
ER -
ID: 236317413