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Mid-term outcomes of alcohol septal ablation for obstructive hypertrophic cardiomyopathy in patients with sigmoid versus neutral ventricular septum.
MedLine Citation:
PMID:  23220977     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to determine whether the differences in the baseline septal morphology influenced outcomes of patients after alcohol septal ablation (ASA).
METHODS: A total of 100 consecutive, highly symptomatic patients with HOCM and a neutral or sigmoid septum (74 patients vs 26 patients) underwent ASA and were examined clinically and echocardiographically at baseline and at follow-up (median 30 months vs 24 months).
RESULTS: At baseline, a neutral septum morphology was associated with a thicker basal septum [21 (19-24) mm vs 19 (18-20) mm; P<0.01] and higher pressure gradient at rest [59 (39-80) mm vs 43 (33-50) mm; P<0.01], but a similar pressure gradient after provocation [100 (72-120) mmHg vs 97 (70-110) mmHg; P=0.31], and subsequently both resting gradient [10 (10-16) mmHg vs 12 (10-15) mmHg; P=0.67] and provoked gradient after ASA [20 (10- 30) mmHg vs 18 (12-25) mmHg; P=0.71]. Four patients died during follow-up (4% vs 4%; NS). Pressure gradient, septum thickness and symptoms decreased significantly in both groups.
CONCLUSIONS: Patients treated with ASA who had a sigmoid septum were characterized at baseline by a thinner basal septum and lower pressure gradient at rest. However, they showed an identical pressure gradient after provocation and subsequently after ASA. ASA was safe and effective in both groups of patients.
Authors:
Josef Veselka; Pavol Tomasov; David Zemánek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  24     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  636-40     Citation Subset:  IM    
Affiliation:
Dept. of Cardiology, University Hospital Motol, V uvalu 84, Prague 5, 15000, Czech Republic. josef.veselka@fnmotol.cz.
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