CardiomyopathyBiventricular Reverse Remodeling After Successful Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy
Section snippets
Methods
The study protocol was approved by the Institutional Ethics Committee of Fuwai Hospital. All patients gave informed consent before enrollment in the study. We studied 38 patients with obstructive HC who underwent ASA procedures from August 2005 to December 2012. Indications for ASA included severe, drug-refractory, New York Heart Association functional class III or IV heart failure with an LVOT gradient >50 mm Hg at rest or >100 mm Hg during provocation.11 No patients had previous surgical
Results
The study cohort had a mean age of 48 ± 9 years, and 28 of the 38 patients (74%) were men. Thirteen patients (34%) had angina pectoris, 8 (21%) had syncope, 29 (76%) had New York Heart Association functional class III or IV symptoms, and 8 (21%) had family histories of HC or sudden cardiac death (Table 1). The median follow-up time was 16 months (range 9 to 39).
ASA resulted in significant reductions of LVOT gradient at rest in all patients. The mean LVOT gradient decreased from 89 ± 22 to 34 ±
Discussion
In this study, we demonstrated LV and RV reverse remodeling after successful ASA, evidenced by the reductions of RV and LV mass as well as increased RV and LV end-diastolic volumes. Also, LVOT gradient reduction was correlated significantly with reductions in LV remote mass and RV mass during the 16-month follow-up. Furthermore, the reverse biventricular remodeling was accompanied by an improvement in functional status, evidenced by improvement in New York Heart Association functional class and
Acknowledgment
The authors thank Medis Medical Imaging Systems and QMass Software (version 7.6) for their support.
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