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Left ventricular longitudinal systolic function after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a long-term follow-up study focused on speckle tracking echocardiography.
MedLine Citation:
PMID:  20667848     Owner:  NLM     Status:  In-Process    
AIMS: To examine left ventricular (LV) longitudinal systolic myocardial function in patients with hypertrophic obstructive cardiomyopathy (HOCM) before and after transcoronary ablation of septal hypertrophy (TASH).
METHODS AND RESULTS: Twenty-three of 39 consecutive patients with HOCM had serial two-dimensional (2D) echocardiograms available for speckle tracking analyses before and up to 36 months after TASH. Before TASH, overall LV myocardial longitudinal systolic 2D strain was decreased despite normal LV ejection fraction (EF). A significant reduction of LV mass and left ventricular outflow tract (LVOT) gradients occurred during long-term follow-up after TASH, but this was not accompanied by improvement of average LV longitudinal systolic strain. However, in the basal LV segments remote to the site of alcohol injection longitudinal systolic strain increased [baseline: -13.1 ± 5.4%; 1 month: -16.0 ± 5.5% (NS); 12 months: -16.5 ± 4.9% (P < 0.05 vs. baseline); 36 months: -17.4 ± 4.2% (P < 0.01 vs. baseline)]. In contrast, the alcohol-treated basal segments of the septum and adjacent myocardium showed unchanged strain over time.
CONCLUSION: Average LV longitudinal myocardial systolic function is depressed in HOCM despite normal LV EF. TASH-induced reduction of the LVOT obstruction does not improve average LV longitudinal systolic 2D strain. This is in contrast to global improvement of longitudinal systolic function after valve replacement in aortic valve stenosis. The discrepancy may be caused by the fact that HOCM is a primary myocardial disease.
Anders Sommer; Steen Hvitfeldt Poulsen; Jens Mogensen; Leif Thuesen; Henrik Egeblad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-28
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  11     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  883-8     Citation Subset:  IM    
Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
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