Left Ventricular Systolic Function Following Alcohol Septal Ablation for Symptomatic Hypertrophic Cardiomyopathy

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• 作者：Travis J. Moss ; MD^a ; Mori J. Krantz ; MD^a ; ^b ; Matthew M. Zipse ; MD^a ; Robert A. Quaife ; MD^a ; William H. Sauer ; MD^a ; John C. Messenger ; MD^a ; Bertron M. Groves ; MD^a ; Ernesto E. Salcedo ; MD^a ; Joseph L. Schuller ; MD^a ; ^b ; ^{joseph.schuller@ucdenver.edu" class="auth_mail}
• 刊名：The American Journal of Cardiology
• 出版年：15 April, 2014
• 年：2014
• 卷：113
• 期：8
• 页码：1401-1404
• 全文大小：258 K

文摘

Because alcohol septal ablation (ASA) for the treatment of symptomatic hypertrophic cardiomyopathy (HC) with left ventricular (LV) outflow tract (LVOT) obstruction results in a myocardial infarct of up to 10% of ventricular mass, LV systolic function could decline over time. We evaluated LV function during longitudinal follow-up in a cohort of patients who underwent ASA. We studied 145 consecutive patients with HC that underwent 167 ASA procedures from 2002 to 2011. Echocardiographic follow-up was available in 139 patients (96%). Echocardiographic indexes included LV ejection fraction (LVEF), mitral regurgitation severity, systolic anterior motion of the anterior mitral leaflet, and resting and provoked LVOT gradients. All patients had a baseline LVEF of >55%. LVEF was preserved in 97.1% of patients over a mean follow-up time of 3.1 卤 2.3聽years (maximum 9.7). Mild LV systolic dysfunction was observed (LVEF range 44% to 54%) in only 4 patients. Mitral regurgitation severity improved in 67% (n聽= 112 of 138 with complete data). Resting LVOT gradient declined from a mean of 75 to 19聽mm Hg (p <0.001), and provoked gradient declined from a mean of 101 to 33聽mm Hg (p <0.001). New York Heart Association class improved from a mean of 2.9 卤 0.4 to 1.3 卤 0.5 (p <0.001). In conclusion, LV systolic function is only mildly reduced in a minority of patients after ASA for symptomatic HC; other echocardiographic and functional measures were significantly improved.