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Effectiveness of Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy With Versus Without Extreme

Yin-Jian Yang, Chao-Mei Fan1, Jin-Qing Yuan2

  • 1Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, 167 Beilishi Rd, Xi Cheng District, Beijing, China 100037. fancm2004@126.com.

The Journal of Invasive Cardiology
|March 6, 2016
PubMed

Insights

Alcohol septal ablation (ASA) is effective for hypertrophic cardiomyopathy (HCM) with extreme septal hypertrophy (ESH). This study found ASA effectiveness comparable between patients with and without ESH.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Hypertrophic Cardiomyopathy Research

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease.
  • Extreme septal hypertrophy (ESH) is a specific anatomical characteristic in some HCM patients.
  • Limited data exists on the efficacy of alcohol septal ablation (ASA) in HCM patients with ESH.

Purpose of the Study:

  • To compare the effectiveness of alcohol septal ablation (ASA) in patients with hypertrophic cardiomyopathy (HCM) who have extreme septal hypertrophy (ESH) versus those without ESH.
  • To evaluate if ESH influences the outcomes of ASA in HCM patients.

Main Methods:

  • A comparative study involving 17 patients with ESH and 256 patients without ESH (N-ESH).
  • Clinical profiles and follow-up data were analyzed after ASA.
  • Key outcome measures included pressure gradient and symptom severity (NYHA/CCS classes).

Main Results:

  • Baseline pressure gradients and limiting symptoms were similar between the ESH and N-ESH groups.
  • At a median follow-up of 1.1 years, pressure gradients were comparable (48.5 ± 40.4 mm Hg in ESH vs. 40.9 ± 35.2 mm Hg in N-ESH, P=.33).
  • Symptom improvement, assessed by NYHA and CCS classifications, showed no significant difference between groups (P=.39 and P=.87, respectively).

Conclusions:

  • Alcohol septal ablation (ASA) demonstrates comparable effectiveness in patients with hypertrophic cardiomyopathy (HCM) regardless of the presence of extreme septal hypertrophy (ESH).
  • ESH does not appear to be a limiting factor for the success of ASA in HCM treatment.
Abstract

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