Follow-Up Study of Percutaneous Intramyocardial Septal Radiofrequency Ablation in the Treatment of Hypertrophic
Chang Wang1, Weitao Guo1, Huican Duan1
1Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Insights
Percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) significantly improved diastolic function and reduced symptoms in hypertrophic cardiomyopathy patients with heart failure with preserved ejection fraction (HFpEF). This safe and effective treatment enhances quality of life.
Area of Science:
- Cardiology
- Interventional Cardiology
- Heart Failure Research
Background:
- Hypertrophic cardiomyopathy (HCM) can lead to heart failure with preserved ejection fraction (HFpEF).
- Left ventricular diastolic dysfunction is a key feature in HCM-HFpEF.
- Current treatment options for HCM-HFpEF require further evaluation.
Purpose of the Study:
- To assess the impact of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) on diastolic function in HCM patients with HFpEF.
- To evaluate the improvement in clinical symptoms and quality of life following PIMSRA.
Main Methods:
- A cohort of 31 adult patients with HCM and HFpEF underwent PIMSRA.
- Comprehensive assessments including ECG, cardiac imaging, and blood tests were conducted pre- and post-procedure over a 6-month follow-up.
Main Results:
- PIMSRA significantly reduced left ventricular outflow tract pressure gradients and interventricular septal thickness.
- Diastolic function, indicated by decreased E/e', improved markedly.
- Patients experienced significant improvements in 6-minute walk distance and quality of life (KCCQ OS).
- The diagnosis of HFpEF decreased post-procedure, with no new conduction blocks observed.
Conclusions:
- PIMSRA is a safe and effective therapeutic option for HCM patients with HFpEF.
- The procedure demonstrably improves left ventricular diastolic function.
- PIMSRA leads to enhanced clinical status and quality of life in this patient population.
Background:
The study aimed to evaluate the changes of left ventricular diastolic function and the improvement of clinical symptoms in hypertrophic cardiomyopathy (HCM) patients with heart failure with preserved ejection fraction (HFpEF) after percutaneous intramyocardial septal radiofrequency ablation (PIMSRA).
Methods:
This study enrolled 31 adult HCM patients with HFpEF who underwent PIMSRA treatment. Electrocardiogram, imaging, and blood biochemical examinations were performed on these patients during a 6-month follow-up.
Results:
Compared with the baseline, at 6 months after PIMSRA, patients showed significant reductions in peak left ventricular outflow tract pressure gradients (resting gradient: from a mean of 83.24 to 23.40 mmHg, p < 0.001; postexercise gradient: from a mean of 109.70 to 33.39 mmHg, p< 0.001). The interventricular septal thickness reduced from a mean of 22.90 to 17.48 mm, p < 0.001. The E/e' decreased from a median of 18.67 to 11.54, p < 0.001. The 6-minute walk distance (6MWD) increased from a mean of 359.03 to 435.81 m, p < 0.001. The Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ OS) increased from a mean of 57.57 to 71.93, p < 0.001. The number of HFpEF patients diagnosed according to the European Society of Cardiology's Heart Failure Association HFA-PEFF score decreased from 31 to 23. None of the patients had new-onset bundle branch block or complete heart block after PIMSRA.
Conclusion:
PIMSRA is a safe and effective treatment. It can improve left ventricular diastolic function and quality of life in HCM patients.
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