Related Experiment Video
Updated: Aug 20, 2026
Ultrasonic Assessment of Myocardial Microstructure
Published on: January 14, 2014
Quantitative analysis of intraprocedural myocardial contrast echocardiography during percutaneous septal ablation for
Detlef Hering1, Dirk Welge, Dieter Fassbender
1Department of Cardiology, Heart Center North Rhine-Westphalia, Ruhr University, Georgstrasse 11, 32545 Bad Oeynhausen, Germany. akohlstaedt@hdz-nrw.de
Insights
Procedural success in hypertrophic obstructive cardiomyopathy ablation using percutaneous septal ablation is predicted by contrast depot location, not quantitative echocardiography measurements. Final hemodynamic effects depend on individual patient remodeling.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Imaging
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) presents a significant clinical challenge.
- Percutaneous septal ablation is an emerging treatment option for HOCM.
- Myocardial contrast echocardiography (MCE) is used intraprocedurally.
Purpose of the Study:
- To determine if quantitative intraprocedural MCE measurements correlate with procedural success of percutaneous septal ablation for HOCM.
- To assess the relationship between contrast depot characteristics and ablation lesion efficacy.
Main Methods:
- A study group of 34 patients undergoing percutaneous septal ablation for HOCM.
- Quantitative measurements of the contrast depot (area, length, proximal edge) during MCE.
- Assessment of clinical and hemodynamic success 3 months post-ablation.
- Correlation analysis between MCE parameters and ablation outcomes.
Main Results:
- The mean contrast depot area was 8.5 cm², length 3.0 cm, and proximal edge 2.0 cm from mitral-septal contact.
- Clinical and hemodynamic success was achieved in 33 out of 34 patients.
- A weak correlation (r=0.5) was found between the ablation lesion's proximal edge and the contrast depot's proximal edge relative to the mitral valve.
- No other significant correlations were identified between MCE quantitative parameters and procedural efficacy.
Conclusions:
- The location of the contrast depot intraprocedurally predicts the 3-month localization of the ablation lesion in HOCM.
- The final hemodynamic improvement after percutaneous septal ablation is not directly correlated with quantitative intraprocedural MCE parameters.
- Individual patient remodeling appears to be the primary driver of the long-term hemodynamic effect post-ablation.
Aims:
We tested whether procedural success of percutaneous septal ablation for hypertrophic obstructive cardiomyopathy is related to quantitative measurements of intraprocedural myocardial contrast echocardiography.
Methods And Results:
In a study group of 34 patients, the mean area of the contrast depot was 8.5+/-2.5 cm2, its length along the left ventricular endocardial border 3.0+/-0.7 cm and its proximal edge 2.0+/-0.6 cm upstream the point of mitral-septal contact. Clinical and hemodynamic success was achieved in all but one patient 3 months following percutaneous septal ablation. The proximal edge of the ablation lesion correlated weakly (r=0.5) with the proximal edge of the contrast depot with respect to their distance from the mitral valve leaflet tips. No other correlations were found between the efficacy of percutaneous septal ablation and various quantitative measurements of intraprocedural contrast echocardiography.
Conclusions:
The localization of the ablation lesion 3 months after percutaneous septal ablation is predicted by the localization of the contrast depot with respect to the point of mitral-septal contact. The final hemodynamic effect of the ablation lesion, however, does not correlate with quantitative parameters of intraprocedural contrast echocardiography, but appears to be the result of an individual remodeling process.
