| Impact of alcohol septal ablation on left anterior descending coronary artery blood flow in hypertrophic obstructive cardiomyopathy. | |
| | |
MedLine Citation:
|
PMID: 19234870 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: The aim of this study was to evaluate the effects of alcohol septal ablation (ASA) on coronary blood flow in symptomatic hypertrophic obstructive cardiomyopathy (HOCM) using cardiac MR (CMR) coronary flow measurements. Background CMR flow mapping enables quantification of coronary blood flow in a noninvasive way. Both left ventricular outflow tract (LVOT) gradient reduction and myocardial scarring after ASA are expected to influence left anterior descending (LAD) coronary blood flow. METHODS: Cine, contrast-enhanced (CE) imaging and breath-hold CMR phase contrast velocity mapping were performed at baseline and 1 and 6 months after ASA in seven patients. Changes of coronary blood flow were related to left ventricular (LV) mass reduction, enzyme release, volume of ethanol administered, LVOT gradient reduction, and LV rate pressure product (LVRPP). RESULTS: A significant mass reduction was observed both in the target septal myocardium and in the total myocardium (both P < 0.01). Mean myocardial infarct size was 23 +/- 12 g (range 7.3-41.6 g). LVRPP decreased from 13,268 +/- 2,212 to 10,685 +/- 3,918 at 1 month (P = 0.05) and 9,483 +/- 2,496 mmHg beats/min at 6 months' follow-up (P < 0.01). LAD coronary blood flow decreased from 100 +/- 37 ml/min at baseline to 84 +/- 54 ml/min (P = 0.09) at 1 month and 67 +/- 33 ml/min at 6 months follow-up (P < 0.01). A significant correlation was found between the change in LVRPP and LAD coronary flow at 1 month follow-up (r = 0.83, P = 0.02). CE-infarct size tended to modulate the blood flow changes over time (P = 0.12); no correlation was observed between enzyme release, volume of ethanol or both septal and total mass reduction and coronary blood flow. CONCLUSION: The reduction in coronary blood flow is primarily associated with diminished LV loading conditions, whereas the induction of metabolically inactive myocardial scar tissue by ASA did not significantly influence the changes in coronary blood flow. |
| | |
Authors:
|
Willem G van Dockum; Paul Knaapen; Mark B M Hofman; Joost P A Kuijer; Folkert J ten Cate; Jurrien M ten Berg; Aernout M Beek; Jos W R Twisk; Albert C van Rossum |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-02-22 |
Journal Detail:
|
Title: The international journal of cardiovascular imaging Volume: 25 ISSN: 1875-8312 ISO Abbreviation: Int J Cardiovasc Imaging Publication Date: 2009 Jun |
Date Detail:
|
Created Date: 2009-05-18 Completed Date: 2009-07-23 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100969716 Medline TA: Int J Cardiovasc Imaging Country: United States |
Other Details:
|
Languages: eng Pagination: 511-8 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, ICaR-VU, VU University Medical Center, De Boelelaan 1117, Amsterdam, The Netherlands. wg.vandockum@vumc.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Cardiomyopathy, Hypertrophic / pathology, physiopathology, therapy* Cicatrix / chemically induced, pathology, physiopathology Coronary Circulation* Echocardiography, Doppler Ethanol / administration & dosage*, adverse effects Female Heart Catheterization* Hemodynamics Humans Infusions, Intra-Arterial Magnetic Resonance Angiography Magnetic Resonance Imaging, Cine Male Middle Aged Myocardial Infarction / chemically induced, pathology, physiopathology Myocardium / pathology* Time Factors Treatment Outcome Ventricular Function, Left |
| Chemical | |
Reg. No./Substance:
|
64-17-5/Ethanol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The clinical implications of myocardial perfusion abnormalities in patients with esophageal or lung ...
Next Document: A dialogical exploration of the grey zone of health and illness: medical science, anthropology, and ...