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Left Ventricular Systolic Function Following Alcohol Septal Ablation for Symptomatic Hypertrophic Cardiomyopathy.
MedLine Citation:
PMID:  24576545     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Because alcohol septal ablation (ASA) for the treatment of symptomatic hypertrophic cardiomyopathy (HC) with left ventricular (LV) outflow tract (LVOT) obstruction results in a myocardial infarct of up to 10% of ventricular mass, LV systolic function could decline over time. We evaluated LV function during longitudinal follow-up in a cohort of patients who underwent ASA. We studied 145 consecutive patients with HC that underwent 167 ASA procedures from 2002 to 2011. Echocardiographic follow-up was available in 139 patients (96%). Echocardiographic indexes included LV ejection fraction (LVEF), mitral regurgitation severity, systolic anterior motion of the anterior mitral leaflet, and resting and provoked LVOT gradients. All patients had a baseline LVEF of >55%. LVEF was preserved in 97.1% of patients over a mean follow-up time of 3.1 ± 2.3 years (maximum 9.7). Mild LV systolic dysfunction was observed (LVEF range 44% to 54%) in only 4 patients. Mitral regurgitation severity improved in 67% (n = 112 of 138 with complete data). Resting LVOT gradient declined from a mean of 75 to 19 mm Hg (p <0.001), and provoked gradient declined from a mean of 101 to 33 mm Hg (p <0.001). New York Heart Association class improved from a mean of 2.9 ± 0.4 to 1.3 ± 0.5 (p <0.001). In conclusion, LV systolic function is only mildly reduced in a minority of patients after ASA for symptomatic HC; other echocardiographic and functional measures were significantly improved.
Authors:
Travis J Moss; Mori J Krantz; Matthew M Zipse; Robert A Quaife; William H Sauer; John C Messenger; Bertron M Groves; Ernesto E Salcedo; Joseph L Schuller
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-31
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-2-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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