دورية أكاديمية
Short- and Long-Term Outcome After Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: Experience of a Reference Center ; Desfecho a Curto e Longo Prazo Após Ablação Septal Alcoólica na Miocardiopatia Hipertrófica Obstrutiva: Experiência num Centro de Referência
| العنوان: | Short- and Long-Term Outcome After Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: Experience of a Reference Center ; Desfecho a Curto e Longo Prazo Após Ablação Septal Alcoólica na Miocardiopatia Hipertrófica Obstrutiva: Experiência num Centro de Referência |
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| المؤلفون: | Aguiar Rosa, S, Fiarresga, A, Galrinho, A, Cacela, D, Ramos, R, de Sousa, L, Gonçalves, A, Bernardes, L, Patrício, L, Branco, LM, Cruz Ferreira, R |
| بيانات النشر: | Elsevier España |
| سنة النشر: | 2019 |
| المجموعة: | Repositório do Centro Hospitalar de Lisboa Central EPE |
| مصطلحات موضوعية: | Ablation Techniques, Cardiac Surgical Procedures, Cardiomyopathy, Hypertrophic, Echocardiography, Ethanol, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Ventricular Outflow Obstruction, Ventricular Septum, HSM CAR |
| الوصف: | Introduction: In obstructive hypertrophic cardiomyopathy (HCM), alcohol septal ablation (ASA) can lead to gradient reduction and symptom improvement. We aimed to assess the efficacy and safety of ASA in a long-term outcome study. Methods: We analyzed patients who underwent ASA over a seven-year period in a tertiary center. The primary echocardiographic endpoint was >50% reduction in left ventricular outflow tract (LVOT) gradient within a year of the procedure. The primary clinical endpoints were improvement in functional capacity and a combined endpoint of cardiac death and rehospitalization for cardiac cause. The follow-up period was 4.17±2.13 years. Results: A total of 80 patients, mean age 63.9±12.3 years, 30.0% male, were analyzed. Baseline LVOT gradient was 96.3±34.6 mmHg and interventricular septal thickness was 21.6±3.1 mm. Minor complications were observed in 6.3% and major complications in 2.5%, and 8.8% received a permanent pacemaker. The primary echocardiographic endpoint was achieved by 85.7%. At three-month follow-up, LVOT gradient was 25.8±26.0 mmHg in the successful procedure group, compared to 69.2±35.6 mmHg in the other patients (p=0.001). At six months, LVOT gradient was 27.1±27.4 vs. 58.2±16.6 mmHg (p=0.024). Among 74 patients in NYHA class III/IV before the procedure, 57 (77%) improved to NHYA class I/II. The combined primary clinical endpoint (cardiac death and rehospitalization for cardiac cause) was observed in 27.5% (n=22). In the unsuccessful group, the combined endpoint was observed in 54.5%, compared to only 22.7% in the successful group. Only two patients died of cardiac causes. Conclusion: ASA is a safe procedure with a high success rate. Patients who achieved significant reductions in LVOT gradient suffered less cardiac death and rehospitalization for cardiac cause. ; info:eu-repo/semantics/publishedVersion |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | Rev Port Cardiol (Engl Ed). 2019 Jul;38(7):473-480.; http://hdl.handle.net/10400.17/3763Test |
| DOI: | 10.1016/j.repc.2019.08.003 |
| الإتاحة: | https://doi.org/10.1016/j.repc.2019.08.003Test http://hdl.handle.net/10400.17/3763Test |
| حقوق: | openAccess |
| رقم الانضمام: | edsbas.8014BF5E |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.repc.2019.08.003 |
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