Document Detail


Septal myectomy results in regression of left ventricular hypertrophy in patients with hypertrophic obstructive cardiomyopathy.
MedLine Citation:
PMID:  15561048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by ventricular hypertrophy that occurs in the absence of predisposing cardiovascular stimuli; approximately one quarter of patients with HCM will have left ventricular (LV) outflow tract obstruction. Transaortic septal myectomy relieves outflow gradients and improves symptoms, but the effect of operation on ventricular hypertrophy is not well defined. METHODS: We reviewed 60 patients who underwent septal myectomy for obstructive HCM; all had complete two-dimensional and Doppler studies including calculation of LV mass and LV mass index before operation and after dismissal. RESULTS: Before myectomy the mean LV outflow gradient was 67 +/- 44 mm Hg, and at dismissal the mean LV outflow gradient was 12 +/- 13 mm Hg (p < 0.004). We found a significant decrease in the LV mass and LV mass index that occurred early after operation and persisted beyond 2 years follow-up. The early decrease in LV mass was greatest in patients younger than 50 years, but patients of all ages benefited from extended septal myectomy with decrease in LV hypertrophy. CONCLUSIONS: Transaortic septal myectomy results in significant decreases in LV mass and LV mass index. This favorable remodeling occurs early after operation and persists beyond 2 years. Whether the regression of LV mass continues to decrease or stabilize over time is unclear.
Authors:
Subrato J Deb; Hartzell V Schaff; Joseph A Dearani; Rick A Nishimura; Steve R Ommen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  78     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-24     Completed Date:  2005-07-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2118-22     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Adult
Aged
Calcium Channel Blockers / therapeutic use
Cardiomyopathy, Hypertrophic / drug therapy,  surgery*,  ultrasonography
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Septum / surgery*
Humans
Hypertrophy, Left Ventricular / surgery*,  ultrasonography
Male
Middle Aged
Pregnancy
Stroke Volume
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Calcium Channel Blockers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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