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

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.