Document Detail


Comparison of left ventricular diastolic function in obstructive hypertrophic cardiomyopathy in patients undergoing percutaneous septal alcohol ablation versus surgical myotomy/myectomy.
MedLine Citation:
PMID:  12667567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Both percutaneous transcoronary alcohol septal reduction (ASR) and surgical myectomy are effective treatments to relieve left ventricular (LV) outflow tract obstruction in obstructive hypertrophic cardiomyopathy (HC). LV diastolic function was assessed by echocardiography in 57 patients with obstructive HC at baseline and 5 +/- 4 months after ASR (n = 37) or surgical myectomy (n = 20). LV outflow tract pressure gradient decreased from 65 +/- 40 to 23 +/- 21 mm Hg (p <0.01) after treatment. The ratio of the early-to-late peak diastolic LV inflow velocities, and the ratio of the early peak diastolic LV inflow velocity to the lateral mitral annulus early diastolic velocity determined by tissue Doppler imaging significantly decreased after the procedures (1.6 +/- 1.7 vs 1.0 +/- 0.7 and 15 +/- 8 vs 11 +/- 5, respectively), whereas LV inflow propagation velocity significantly increased (60 +/- 24 vs 71 +/- 36 cm/s). Left atrial size decreased from 29 +/- 7 to 25 +/- 6 cm(2) (p <0.05). Patients had a significant improvement in New York Heart Association functional class and in exercise performance. When comparing ASR with myectomy, no difference was found in the degree of change in any parameter of diastolic function. Thus, diastolic function indexes obtained by echocardiography changed after septal reduction interventions in patients with obstructive HC; this change was similar to that after surgical myectomy and ASR.
Authors:
Marta Sitges; Takahiro Shiota; Harry M Lever; Jian Xin Qin; Fabrice Bauer; Jeannie K Drinko; Deborah A Agler; Maureen G Martin; Neil L Greenberg; Nicholas G Smedira; Bruce W Lytle; E Murat Tuzcu; Mario J Garcia; James D Thomas
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  91     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-01     Completed Date:  2003-05-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  817-21     Citation Subset:  AIM; IM; S    
Affiliation:
Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cardiac Surgical Procedures*
Cardiomyopathy, Hypertrophic / physiopathology*,  therapy*
Catheter Ablation*
Ethanol / therapeutic use*
Exercise / physiology
Female
Follow-Up Studies
Heart Septum / physiopathology*,  surgery*
Heart Ventricles / physiopathology,  surgery
Humans
Male
Middle Aged
Mitral Valve Insufficiency / physiopathology,  therapy
Reoperation
Stroke Volume / physiology*
Treatment Outcome
Ventricular Function, Left / physiology*
Ventricular Outflow Obstruction / physiopathology,  therapy
Chemical
Reg. No./Substance:
64-17-5/Ethanol
Investigator
Investigator/Affiliation:
J D Thomas / Cleveland CLinic Found, OH

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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