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Biventricular reverse remodeling after successful alcohol septal ablation for obstructive hypertrophic cardiomyopathy

You-Zhou Chen1, Shu-Bin Qiao1, Feng-Huan Hu1

  • 1Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

The American Journal of Cardiology
|December 27, 2014
PubMed

Insights

Alcohol septal ablation (ASA) effectively reduces left ventricular outflow tract gradients in hypertrophic cardiomyopathy (HC). This procedure promotes positive biventricular reverse remodeling, decreasing both left and right ventricular mass and improving function long-term.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Obstructive hypertrophic cardiomyopathy (HC) presents challenges in medical management.
  • Alcohol septal ablation (ASA) is an intervention for symptomatic obstructive HC.
  • Long-term effects of ASA on biventricular remodeling require further investigation.

Purpose of the Study:

  • To evaluate the long-term impact of ASA on left ventricular (LV) and right ventricular (RV) remodeling.
  • To assess changes in cardiac mass, volumes, and function post-ASA in obstructive HC patients.
  • To correlate gradient reduction with ventricular remodeling parameters.

Main Methods:

  • Cardiovascular magnetic resonance (CMR) imaging performed at baseline and 16 months post-ASA.
  • Study included 38 patients with obstructive HC receiving optimal medical treatment.
  • Analysis focused on LV and RV mass, volumes, ejection fraction, and LV outflow tract gradient.

Main Results:

  • ASA significantly reduced LV outflow tract gradients and improved NYHA functional class.
  • Significant decreases in LV septal and remote mass were observed at 16 months.
  • Significant reductions in RV mass and improvements in RV end-diastolic volume and ejection fraction were noted.

Conclusions:

  • Successful ASA leads to positive biventricular reverse remodeling in obstructive HC.
  • ASA demonstrates sustained reductions in both LV and RV mass.
  • Increased RV and LV end-diastolic volumes indicate improved ventricular filling post-intervention.

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