Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long-Term Follow-Up Study Based on the Euro-Alcohol Septal Ablation Registry


Veselka, Josef, Faber, Lothar, Liebregts, Max, Cooper, Robert, Januska, Jaroslav, Krejci, Jan, Bartel, Thomas, Dabrowski, Maciej, Hansen, Peter Riis, Almaas, Vibeke Marie et al (show 7 more authors) (2017) Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long-Term Follow-Up Study Based on the Euro-Alcohol Septal Ablation Registry. JOURNAL OF THE AMERICAN HEART ASSOCIATION, 6 (5). e005735-.

[img] Text
ModestSymptomsFinall.pdf - Author Accepted Manuscript
Download (837kB)

Abstract

<h4>Background</h4>The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA.<h4>Methods and results</h4>We retrospectively evaluated consecutive patients enrolled in the Euro-ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre-ASA. The median (interquartile range) follow-up was 4.8 (1.7-8.5) years. The clinical outcome was assessed and compared with the age- and sex-matched general population. The 30-day mortality after ASA was 0.6% and the annual all-cause mortality rate was 1.7%, which was similar to the age- and sex-matched general population (<i>P</i>=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (<i>P</i><0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (<i>P</i><0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively.<h4>Conclusions</h4>Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population.

Item Type: Article
Uncontrolled Keywords: ablation, hypertrophic cardiomyopathy, outcome
Depositing User: Symplectic Admin
Date Deposited: 25 Jul 2017 11:45
Last Modified: 13 Feb 2024 15:12
DOI: 10.1161/JAHA.117.005735
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3008606
Dimensions
Altmetric
CORE (COnnecting REpositories)