Received:22 February 2017,
Published:30 August 2017
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Dan DENG, Jing MENG, Xiaolong QU, et al. Clinical efficacy and safety of alcohol septal ablation for hypertrophic obstructive cardiomyopathy[J]. Journal of Third Military Medical University, 2017, 39(16): 1673-1678.
Dan DENG, Jing MENG, Xiaolong QU, et al. Clinical efficacy and safety of alcohol septal ablation for hypertrophic obstructive cardiomyopathy[J]. Journal of Third Military Medical University, 2017, 39(16): 1673-1678. DOI: 10.16016/j.1000-5404.201702120.
Objective
2
To evaluate the clinical efficacy and safety of alcohol septal ablation (ASA) in the treatment of hypertrophic obstructive cardiomyopathy (HOCM).
Methods
2
Forty-four patients with HOCM undergoing ASA between January
2001 and January
2015 were enrolled in this analysis. Catheter technique was used to assess the resting and provoked left ventricular outflow tract gradient (LVOTG) in the patients. Echocardiography was performed at different time points after ASA to assess changes in the resting LVOTG
interventricular septum (IVS)
left ventricular ejection fraction (LVEF)
mitral regurgitation
left atrial volume (LAV)
and left ventricular volume
and the changes of New York Heart Association (NYHA) functional class
and incidence of complications and mortality rate of the patients were recorded after the operation.
Results
2
Catheter measurements showed that both the resting and provoked LVOTG were decreased immediately after ASA from 79.9±37.9 mmHg to 33.8±30.2 mmHg (
P
<
0.01) and from 112.4±43.8 mmHg to 36.8±30.0 mmHg (
P
<
0.01)
respectively. β-blocker was prescribed for routine treatment for all patients after ASA. At 6 months after ASA
the patients showed a significant reduction of the left atrial end-diastolic volume from 113.8±50.3 mL to 97.6±45.7 mL (
P
<
0.01) with increased left ventricular volume and improved left ventricular synchronism and NYHA cardiac function. No episodes of complete atrioventricular block
ventricular fibrillation
or sudden cardiac death occurred in these patients after the operation.
Conclusion
2
ASA is safe and effective for treatment of HOCM in patients with suitable first septal perforator artery
and postoperative medication with β-blockers can provide the patients with long-term benefits.
GERSH B J MARON B J BONOW R O 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the american college of cardiology foundation/american heart association task force on practice guidelines Circulation 2011 124 24 2761 2796 10.1161/CIR.0b013e318223e230 GERSH B J, MARON B J, BONOW R O, et al . 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the american college of cardiology foundation/american heart association task force on practice guidelines[J ] . Circulation, 2011, 124(24): 2761-2796. DOI: 10.1161/ CIR.0b013e318223e230.
CHOUDHURY L RIGOLIN V H BONOW R O Integrated imaging in hypertrophic cardiomyopathy Am J Cardiol 2017 119 2 328 339 10.1016/j.amjcard.2016.09.033 CHOUDHURY L, RIGOLIN V H, BONOW R O. Integrated imaging in hypertrophic cardiomyopathy[J]. Am J Cardiol, 2017, 119(2): 328-339. DOI: 10.1016/j.amjcard.2016.09.033.
CARDOSO B GOMES I LOUREIRO P Clinical and genetic diagnosis of familial hypertrophic cardiomyopathy: results in pediatric cardiology Rev Port Cardiol 2017 36 3 155 165 10.1016/j.repc.2016.09.009 CARDOSO B, GOMES I, LOUREIRO P, et al . Clinical and genetic diagnosis of familial hypertrophic cardiomyopathy: results in pediatric cardiology[J ] . Rev Port Cardiol, 2017, 36(3): 155-165. DOI: 10.1016/j.repc. 2016.09.009.
HO C Y Hypertrophic cardiomyopathy in 2012 Circulation 2012 125 11 1432 1438 10.1161/CIRCULATIONAHA.110.017277 HO C Y. Hypertrophic cardiomyopathy in 2012[J]. Circulation, 2012, 125(11): 1432-1438. DOI: 10.1161/ CIRCULATIONAHA.110.017277.
VESELKA J LAWRENZ T STELLBRINK C Low incidence of procedure-related major adverse cardiac events after alcohol septal ablation for symptomatic hypertrophic obstructive cardiomyopathy Can J Cardiol 2013 29 11 1415 1421 10.1016/j.cjca.2013.04.027 VESELKA J, LAWRENZ T, STELLBRINK C, et al . Low incidence of procedure-related major adverse cardiac events after alcohol septal ablation for symptomatic hypertrophic obstructive cardiomyopathy[J ] . Can J Cardiol, 2013, 29(11): 1415-1421. DOI: 10.1016/j.cjca. 2013.04.027.
SIGWART U Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy Lancet 1995 346 8969 211 214 10.1016/S0140-6736(95)91267-3 SIGWART U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy[J]. Lancet, 1995, 346(8969): 211-214. DOI: 10.1016/S0140-6736(95)91267-3.
AGARWAL S TUZCU E M DESAI M Y Updated meta-analysis of septal alcohol ablation versus myectomy for hypertrophic cardiomyopathy J Am Coll Cardiol 2010 55 8 823 834 10.1016/j.jacc.2009.09.047 AGARWAL S, TUZCU E M, DESAI M Y, et al . Updated meta-analysis of septal alcohol ablation versus myectomy for hypertrophic cardiomyopathy[J ] . J Am Coll Cardiol, 2010, 55(8): 823-834. DOI: 10.1016/j.jacc. 2009.09.047.
JENSEN M K ALMAAS V M JACOBSSON L Long-term outcome of percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: a scandinavian multicenter study Circ Cardiovasc Interv 2011 4 3 256 265 10.1161/CIRCINTERVENTIONS.110.959718 JENSEN M K, ALMAAS V M, JACOBSSON L, et al . Long-term outcome of percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: a scandinavian multicenter study[J ] . Circ Cardiovasc Interv, 2011, 4(3): 256-265. DOI: 10.1161/ CIRCINTERVENTIONS.110.959718.
CHAMNARNPHOL N WISARATAPONG T CHEEWATANAKORNKUL S Alcohol septal ablation without myocardial contrast echocardiography for hypertrophic obstructive cardiomyopathy J Med Assoc Thai 2011 94 11 1299 1303 http://www.ncbi.nlm.nih.gov/pubmed/22256468 CHAMNARNPHOL N, WISARATAPONG T, CHEEWATANAKORNKUL S. Alcohol septal ablation without myocardial contrast echocardiography for hypertrophic obstructive cardiomyopathy[J]. J Med Assoc Thai, 2011, 94(11): 1299-1303.
MENG J QU X HUANG H Intracoronary electrocardiogram during alcohol septal ablation for hypertrophic obstructive cardiomyopathy predicts myocardial injury size Clin Exp Pharmacol Physiol 2016 43 1 75 80 10.1111/1440-1681.12502 MENG J, QU X, HUANG H, et al . Intracoronary electrocardiogram during alcohol septal ablation for hypertrophic obstructive cardiomyopathy predicts myocardial injury size[J ] . Clin Exp Pharmacol Physiol, 2016, 43(1): 75-80. DOI:10.1111/1440-1681.12502.
SORAJJA P VALETI U NISHIMURA R A Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy Circulation 2008 118 2 131 139 10.1161/CIRCULATIONAHA.107.738740 SORAJJA P, VALETI U, NISHIMURA R A, et al . Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy[J ] . Circulation, 2008, 118(2): 131-139. DOI: 10.1161/CIRCULATIONAHA. 107.738740.
胡 厚源 何 国祥 周 林 经皮间隔心肌消融术治疗3例肥厚型梗阻性心肌病 第三军医大学学报 2004 26 11 1002 1004 10.16016/j.1000-5404.2004.11.023 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=200411022 胡厚源, 何国祥, 周林, 等.经皮间隔心肌消融术治疗3例肥厚型梗阻性心肌病[J].第三军医大学学报, 2004, 26(11): 1002-1004. DOI: 10.16016/j.1000-5404. 2004.11.023.
HU H Y HE G X ZHOU L Treatment for hypertrophic obstructive cardiomyopathy by percutaneous transluminal septal myocardial ablation J Third Mil Med Univ 2004 26 11 1002 1004 10.16016/j.1000-5404.2004.11.023 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=200411022 HU H Y, HE G X, ZHOU L, et al . Treatment for hypertrophic obstructive cardiomyopathy by percutaneous transluminal septal myocardial ablation[J ] . J Third Mil Med Univ, 2004, 26(11): 1002-1004.DOI:10. 16016/ j.1000-5404.2004.11.023.
SEN-CHOWDHRY S JACOBY D MOON J C Update on hypertrophic cardiomyopathy and a guide to the guidelines Nat Rev Cardiol 2016 13 11 651 675 10.1038/nrcardio.2016.140 SEN-CHOWDHRY S, JACOBY D, MOON J C, et al . Update on hypertrophic cardiomyopathy and a guide to the guidelines[J ] . Nat Rev Cardiol, 2016, 13(11): 651-675. DOI: 10.1038/nrcardio.2016.140.
FRAICHE A WANG A Hypertrophic cardiomyopathy: new evidence since the 2011 american cardiology of cardiology foundation and american heart association guideline Curr Cardiol Rep 2016 18 8 70 10.1007/s11886-016-0751-8 FRAICHE A, WANG A.Hypertrophic cardiomyopathy: new evidence since the 2011 american cardiology of cardiology foundation and american heart association guideline[J]. Curr Cardiol Rep, 2016, 18(8): 70. DOI: 10.1007/s11886-016-0751-8.
Authors/Task Force Members ELLIOTT P M ANASTASAKIS A 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the european society of cardiology (ESC) Eur Heart J 2014 35 39 2733 2779 10.1093/eurheartj/ehu284 Authors/Task Force Members, ELLIOTT P M, ANASTASAKIS A, et al . 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the european society of cardiology (ESC)[J ] . Eur Heart J, 2014, 35(39): 2733-2779. DOI: 10.1093/eurheartj/ ehu284.
VESELKA J TOMAŠOV P ZEMÁNEK D Long-term effects of varying alcohol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy: a randomized study with a follow-up up to 11 years Can J Cardiol 2011 27 6 763 767 10.1016/j.cjca.2011.09.001 VESELKA J, TOMAŠOV P, ZEMÁNEK D. Long-term effects of varying alcohol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy: a randomized study with a follow-up up to 11 years[J]. Can J Cardiol, 2011, 27(6): 763-767. DOI: 10.1016/ j.cjca.2011.09.001.
VESELKA J LAWRENZ T STELLBRINK C Early outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a european multicenter and multinational study Catheter Cardiovasc Interv 2014 84 1 101 107 10.1002/ccd.25236 VESELKA J, LAWRENZ T, STELLBRINK C, et al . Early outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a european multicenter and multinational study[J ] . Catheter Cardiovasc Interv, 2014, 84(1): 101-107. DOI: 10.1002/ccd.25236.
CHEN S L YE F XU Z L Midterm outcomes of percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy refractory to medication Chin Med J 2006 119 13 1121 1124 http://www.ncbi.nlm.nih.gov/pubmed/16834933 CHEN S L, YE F, XU Z L, et al . Midterm outcomes of percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy refractory to medication[J ] . Chin Med J, 2006, 119(13): 1121-1124.
GIMENO J R TOMÉM T MCKENNA W J Alcohol septal ablation in hypertrophic cardiomyopathy: an opportunity to be taken Rev Esp Cardiol (Engl Ed) 2012 65 4 314 318 10.1016/j.recesp.2011.11.021 GIMENO J R, TOMÉM T, MCKENNA W J. Alcohol septal ablation in hypertrophic cardiomyopathy: an opportunity to be taken[J]. Rev Esp Cardiol (Engl Ed), 2012, 65(4): 314-318. DOI:10.1016/j.recesp. 2011.11.021.
黄 海韵 郭 燕丽 孟 璟 斑点追踪成像在肥厚型梗阻性心肌病患者室间隔化学消融术后随访中的应用价值 第三军医大学学报 2015 37 18 1859 1863 10.16016/j.1000-5404.201506110 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201506110 黄海韵, 郭燕丽, 孟璟, 等.斑点追踪成像在肥厚型梗阻性心肌病患者室间隔化学消融术后随访中的应用价值[J].第三军医大学学报, 2015, 37(18): 1859-1863. DOI:10.16016/j.1000-5404.201506110.
HUANG H Y GUO Y L MENG J Value of speckle tracking imaging in postoperative follow-up of alcohol septal ablation for hypertrophic obstructive cardiomyopathy: report of 19 cases J Third Mil Med Univ 2015 37 18 1859 1863 10.16016/j.1000-5404.201506110 http://aammt.tmmu.edu.cn/oa/DArticle.aspx?type=view&id=201506110 HUANG H Y, GUO Y L, MENG J, et al .Value of speckle tracking imaging in postoperative follow-up of alcohol septal ablation for hypertrophic obstructive cardiomyopathy: report of 19 cases[J ] . J Third Mil Med Univ, 2015, 37(18): 1859-1863. DOI: 10.16016/j.1000-5404.201506110.
SADAT K DIDDI H P KLAS B Live/real time three-dimensional transesophageal echocardiographic assessment of ventricular septal volume and mass before and after myectomy in hypertrophic cardiomyopathy Echocardiography 2013 30 10 1227 1231 10.1111/echo.12375 SADAT K, DIDDI H P, KLAS B, et al . Live/real time three-dimensional transesophageal echocardiographic assessment of ventricular septal volume and mass before and after myectomy in hypertrophic cardiomyopathy[J ] . Echocardiography, 2013, 30(10): 1227-1231. DOI: 10. 1111/echo.12375.
STEENDIJK P MELIGA E VALGIMIGLI M Acute effects of alcohol septal ablation on systolic and diastolic left ventricular function in patients with hypertrophic obstructive cardiomyopathy Heart 2008 94 10 1318 1322 10.1136/hrt.2007.139535 STEENDIJK P, MELIGA E, VALGIMIGLI M, et al . Acute effects of alcohol septal ablation on systolic and diastolic left ventricular function in patients with hypertrophic obstructive cardiomyopathy[J ] . Heart, 2008, 94(10): 1318-1322. DOI: 10.1136/hrt.2007.139535.
TANI T YAGI T KITAI T Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy Cardiovasc Ultrasound 2011 9 34 10.1186/1476-7120-9-34 TANI T, YAGI T, KITAI T, et al . Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy[J ] . Cardiovasc Ultrasound, 2011, 9: 34. DOI: 10.1186/1476-7120-9-34.
KUHN H LAWRENZ T LIEDER F Survival after transcoronary ablation of septal hypertrophy in hypertrophic obstructive cardiomyopathy (TASH): a 10 year experience Clin Res Cardiol 2008 97 4 234 243 10.1007/s00392-007-0616-7 KUHN H, LAWRENZ T, LIEDER F, et al . Survival after transcoronary ablation of septal hypertrophy in hypertrophic obstructive cardiomyopathy (TASH): a 10 year experience[J ] . Clin Res Cardiol, 2008, 97(4): 234-243. DOI: 10.1007/s00392-007-0616-7.
LAWRENZ T BORCHERT B LEUNER C Endocardial radiofrequency ablation for hypertrophic obstructive cardiomyopathy: acute results and 6 months' follow-up in 19 patients J Am Coll Cardiol 2011 57 5 572 576 10.1016/j.jacc.2010.07.055 LAWRENZ T, BORCHERT B, LEUNER C, et al . Endocardial radiofrequency ablation for hypertrophic obstructive cardiomyopathy: acute results and 6 months' follow-up in 19 patients[J ] . J Am Coll Cardiol, 2011, 57(5): 572-576. DOI: 10.1016/j.jacc.2010.07.055.
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