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Effects of alcohol septal ablation on left ventricular diastolic filling patterns in obstructive hypertrophic

You-Zhou Chen1, Fu-Jian Duan2, Jian-Song Yuan1

  • 1State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, XiCheng District, Beijing, 100037, China.

Heart and Vessels
|March 6, 2015
PubMed

Insights

Alcohol septal ablation (ASA) significantly improves diastolic function in hypertrophic cardiomyopathy (HCM) patients. Cardiac magnetic resonance (CMR) and echocardiography confirm mid-term benefits, showing enhanced left ventricular filling post-procedure.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Interventional Cardiology

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) is characterized by impaired left ventricular (LV) diastolic function.
  • Alcohol septal ablation (ASA) is a treatment for obstructive HCM, but its effect on diastolic function assessed by cardiac magnetic resonance (CMR) requires further investigation.
  • Understanding mid-term changes in diastolic function post-ASA is crucial for evaluating treatment efficacy.

Purpose of the Study:

  • To investigate mid-term changes in LV diastolic function using both CMR and echocardiography in patients with obstructive HCM following ASA.
  • To correlate improvements in diastolic function with reductions in LV outflow tract (LVOT) gradients after ASA.

Main Methods:

  • A cohort of 43 obstructive HCM patients underwent ASA.
  • Diastolic function was assessed using echocardiography (E/E', E-wave deceleration time) and CMR (peak filling rate [PFR], time to peak filling rate [TPFR]) at a median 14-month follow-up.
  • Correlation analysis was performed between changes in LVOT gradients and diastolic function parameters.

Main Results:

  • Significant improvements in echocardiographic diastolic function were observed, including decreased E/E' ratio and E-wave deceleration time (p < 0.001).
  • CMR assessment revealed a significant increase in PFR and a decrease in TPFR post-ASA (p < 0.001).
  • Greater reductions in LVOT gradients correlated with more substantial improvements in LV diastolic function (p < 0.001).

Conclusions:

  • Successful ASA leads to significant mid-term improvements in both echocardiographic and CMR-derived indices of LV diastolic function.
  • ASA effectively reduces LVOT gradients and mitral regurgitation, which likely contribute to enhanced diastolic function.
  • CMR provides valuable insights into the functional recovery of diastolic function after ASA in HCM patients.

Keywords:
Alcohol septal ablationDiastolic dysfunctionHypertrophic cardiomyopathy

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