Left ventricular longitudinal systolic function after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a long-term follow-up study focused on speckle tracking echocardiography.
نویسندگان
چکیده
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.
منابع مشابه
[Left ventricular remodeling in patients with hypertrophic obstructive cardiomyopathy treated with percutaneous alcohol septal ablation: an echocardiographic study].
INTRODUCTION In patients with hypertrophic obstructive cardiomyopathy, obstruction in the left ventricular outflow tract may generate more hypertrophy. Our aim was to evaluate the impact of reducing ventricular outflow tract obstruction on left ventricular hypertrophy and remodeling after alcohol septal ablation. PATIENTS AND METHOD 20 patients with hypertrophic obstructive cardiomyopathy who...
متن کاملDetection of myocardial infarction by delayed contrast-enhanced multislice computed tomography.
1. Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet 1995;346:211–214. 2. Lakkis N, Nagueh SF, Kleiman NS, Killip D, He ZX, Verani MS, Roberts R, Spencer WH III. Echocardiography-guided ethanol septal ablation for hypertrophic obstructive cardiomyopathy. Circulation 1998;98: 1750–1755. 3. Knight C. Alcohol septal ablation for obstructive hypertroph...
متن کاملAlcohol septal ablation for obstructive hypertrophic cardiomyopathy.
Treatment of obstructive hypertrophic cardiomyopathy remains challenging. Medical therapy, surgical therapy, and pacemaker therapy have been shown to be beneficial in some patients over the years. Alcohol septal ablation is a catheter-based intervention that causes a controlled infarct in the septum leading to a decrease in the left ventricular outflow tract obstruction. Along with the impressi...
متن کامل[Clinical and echocardiographic follow-up of patients with hypertrophic obstructive cardiomyopathy treated by percutaneous septal ablation].
INTRODUCTION AND OBJECTIVES Alcohol septal ablation is a therapeutic option for patients with hypertrophic obstructive cardiomyopathy who remain symptomatic despite medical treatment. Our aim was to monitor clinical and echocardiographic progression in patients with hypertrophic obstructive cardiomyopathy treated by septal ablation at our center. METHODS Thirty-five septal ablations were perf...
متن کاملArrhythmia/Electrophysiology Survival After Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy
Background—The clinical efficacy of alcohol septal ablation for obstructive hypertrophic cardiomyopathy (HCM) has been demonstrated, but the long-term effects of the procedure remain uncertain. This study examined the survival of patients after septal ablation performed in a tertiary HCM referral center. Methods and Results—We examined 177 patients (mean age, 64 years; 68% women) who underwent ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology
دوره 11 10 شماره
صفحات -
تاریخ انتشار 2010