Document Detail


Sustained improvement in left ventricular diastolic function after alcohol septal ablation for hypertrophic obstructive cardiomyopathy.
MedLine Citation:
PMID:  16774986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Impaired diastolic function is responsible for many of the clinical features of hypertrophic cardiomyopathy. In patients with hypertrophic obstructive cardiomyopathy (HOCM) whose symptoms are refractory to medical therapy, alcohol septal ablation (ASA) reduces left ventricular (LV) outflow tract gradient, with short-term improvement in LV diastolic function. Little is known about the longer term impact of ASA on diastolic function. METHODS AND RESULTS: We evaluated LV diastolic function at baseline and 1- and 2-year follow-up after successful ASA. In 30 patients (58+/-15 years, 22 men) who underwent successful ASA, New York Heart Association class was lower at 1-year follow-up compared with baseline (3.0+/-0.5 to 1.5+/-0.7; P<0.0001). LV outflow tract gradient (76+/-37 to 19+/-12; P<0.0001), interventricular septal thickness (19+/-2 to 14+/-2; P<0.0001), and left atrial volume (26+/-5 to 20+/-4; P<0.0001) were decreased. Significant improvement in E-wave deceleration time, isovolumic relaxation time, early diastolic mitral lateral annular velocity (E'), mitral inflow propagation velocity (V(p)), ratio of transmitral early LV filling velocity (E) to early diastolic Doppler tissue imaging of the mitral annulus (E/E'), and E/V(p) were observed at 1 year following successful ASA. These changes persisted in the subset cohort (n=21) for whom 2-year data were available. CONCLUSION: Successful ASA for HOCM leads to significant and sustained improvement in echocardiographic measures of diastolic function, which may contribute to improved functional status after successful ASA.
Authors:
Davinder S Jassal; Tomas G Neilan; Michael A Fifer; Igor F Palacios; Patrica A Lowry; Gus J Vlahakes; Michael H Picard; Danita M Yoerger
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Publication Detail:
Type:  Journal Article     Date:  2006-06-14
Journal Detail:
Title:  European heart journal     Volume:  27     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-18     Completed Date:  2007-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1805-10     Citation Subset:  IM    
Affiliation:
Cardiac Ultrasound Laboratory, Cardiology Division, Massachusetts General Hospital, Boston, MA 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiomyopathy, Hypertrophic / therapy*,  ultrasonography
Echocardiography
Ethanol / therapeutic use*
Female
Heart Septum
Humans
Male
Middle Aged
Sclerosing Solutions / therapeutic use*
Solvents / therapeutic use*
Treatment Outcome
Ventricular Dysfunction, Left / therapy*,  ultrasonography
Chemical
Reg. No./Substance:
0/Sclerosing Solutions; 0/Solvents; 64-17-5/Ethanol
Comments/Corrections
Comment In:
Eur Heart J. 2006 Aug;27(15):1769-70   [PMID:  16801326 ]
Eur Heart J. 2006 Dec;27(23):2901-2; author reply 2902   [PMID:  17032688 ]

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