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A Clinical Study of Precision Chemoablation for Hypertrophic Obstructive Cardiomyopathy Without Large

Xinnan Cao1, Rong Huang1, Haihua Geng1

  • 1Department of Cardiology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China.

Clinical Cardiology
|February 25, 2025
PubMed

Insights

Ultrasound-guided percutaneous septal precision chemical ablation effectively treats hypertrophic obstructive cardiomyopathy (HOCM) by reducing outflow tract obstruction. This safe procedure significantly improves patients' quality of life and functional capacity within one year.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) presents a significant clinical challenge, often leading to debilitating symptoms and reduced quality of life.
  • Current treatment options for HOCM may be limited or carry substantial risks.
  • There is a need for effective and safe interventions to manage left ventricular outflow tract obstruction in HOCM patients.

Purpose of the Study:

  • To evaluate the clinical efficacy and safety of ultrasound-guided percutaneous septal precision chemical ablation (PTSMA) for HOCM.
  • To assess the impact of PTSMA on left ventricular outflow tract gradient (LVOTG), patient-reported outcomes, and cardiac function.

Main Methods:

  • A cohort of 27 HOCM patients without large septal branches underwent ultrasound-guided PTSMA.
  • Key parameters monitored included intraoperative and postoperative LVOTG, cardiac troponin I (cTnI), complications, SF-36 scores, NYHA classification, and echocardiographic measures.
  • Data were analyzed at immediate post-procedure and 1-year follow-up.

Main Results:

  • PTSMA significantly reduced LVOTG immediately post-procedure and at 1-year follow-up (p < 0.05).
  • Patients reported significant improvements across all domains of the SF-36 quality of life scale and NYHA functional classification (p < 0.05).
  • One transient complication (right bundle branch block) occurred; no significant changes in interventricular septal thickness or ejection fraction were noted.

Conclusions:

  • Ultrasound-guided precision PTSMA is a safe and effective treatment for HOCM.
  • The procedure successfully reduces left ventricular outflow tract obstruction.
  • PTSMA significantly enhances the quality of life for HOCM patients.
Abstract

Keywords:
cardiomyopathygelatin spongehypertrophicinterventricular septal branchespercutaneous transluminal septal myocardial ablationultrasonic cardiogram

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