Document Detail


Induction of subaortic septal ischaemia to reduce obstruction in hypertrophic obstructive cardiomyopathy. Studies to develop a new catheter-based concept of treatment.
MedLine Citation:
PMID:  9152655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To develop a new catheter-based method of treatment in patients with hypertrophic obstructive cardiomyopathy. METHOD: Does abolition of the blood supply to the subaortic part of the septum lead to regional myocardial ischaemia and a decrease in the left ventricular outflow tract gradient? To find this out, in 10 consecutive patients the first larger septal branch of the left anterior descending coronary artery was temporarily occluded with conventional percutaneous transluminal coronary angioplasty. The intracoronary electrocardiogram was registered for objective verification of the intended ischaemia. The intraventricular pressure was measured at rest and at the post extrasystolic beat under programmed electrostimulation of the right ventricle. RESULTS: During occlusion, regional ischaemia was observed in all patients. Simultaneously, there was a significant reduction of the intraventricular gradient from 56.2 mmHg to 32.2 mmHg (P < 0.05) followed by an increase from 32.2 mmHg to 61.1 mmHg (P < 0.01) after release of occlusion of the septal branch. During ischaemia there was no increase in left ventricular end-diastolic pressure. CONCLUSION: We conclude that the results form the basis for a new catheter interventional therapy in hypertrophic obstructive cardiomyopathy.
Authors:
H Kuhn; F Gietzen; C Leuner; T Gerenkamp
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  18     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-07-25     Completed Date:  1997-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  846-51     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine II, Bielefeld Hospital, Academic Teaching Hospital, University of Münster, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Balloon Dilatation*
Cardiomyopathy, Hypertrophic / physiopathology,  therapy*
Coronary Angiography
Coronary Circulation / physiology
Electrocardiography
Female
Hemodynamics / physiology
Humans
Male
Middle Aged
Myocardial Ischemia / physiopathology
Treatment Outcome
Ventricular Function, Left / physiology
Ventricular Outflow Obstruction / physiopathology,  therapy*
Comments/Corrections
Comment In:
Eur Heart J. 1997 Dec;18(12):2011-2   [PMID:  9447332 ]
Eur Heart J. 1997 May;18(5):709-10   [PMID:  9152637 ]

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