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Relation of immediate decrease in ventricular septal strain after alcohol septal ablation for obstructive

Jan van Ramshorst1, Sjoerd A Mollema, Victoria Delgado

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

The American Journal of Cardiology
|May 26, 2009
PubMed

Insights

An immediate drop in septal strain after alcohol septal ablation (ASA) for hypertrophic cardiomyopathy (HC) predicts long-term success. This early change in strain can help determine if ASA will effectively reduce left ventricular outflow tract (LVOT) obstruction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Obstructive hypertrophic cardiomyopathy (HC) causes left ventricular outflow tract (LVOT) obstruction.
  • Alcohol septal ablation (ASA) is a treatment option for severe, drug-refractory HC.
  • Predictors for long-term ASA success are currently lacking.

Purpose of the Study:

  • To investigate if an immediate decrease in septal longitudinal strain after ASA can predict sustained LVOT gradient reduction at 6 months.
  • To identify early diagnostic variables for predicting long-term ASA success in HC patients.

Main Methods:

  • 22 patients with HC and severe symptoms underwent ASA.
  • Echocardiography was performed pre-procedure, 1 day post-procedure, and at 6-month follow-up.
  • Septal strain and LVOT gradient were measured and analyzed.

Main Results:

  • New York Heart Association class improved and LVOT gradient significantly decreased at 6 months post-ASA.
  • A significant decrease in basal and midseptal strain was observed 1 day after ASA.
  • The immediate decrease in septal strain strongly correlated with the 6-month LVOT gradient reduction.

Conclusions:

  • An early reduction in septal strain after ASA is a strong predictor of long-term LVOT gradient decrease in HC patients.
  • This immediate strain change may serve as an early determinant of ASA procedural success.
  • This finding offers a potential diagnostic tool for predicting treatment outcomes in obstructive HC.

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