Abstract:
OBJECTIVES:This study sought to determine the impact of surgical myectomy on long-term survival in hypertrophic cardiomyopathy (HCM). BACKGROUND:Left ventricular (LV) outflow tract obstruction in HCM increases the likelihood of heart failure and cardiovascular death. Although surgical myectomy is the primary treatment for amelioration of outflow obstruction and advanced drug-refractory heart failure symptoms, its impact on long-term survival remains unresolved. METHODS:Total and HCM-related mortality were compared in three subgroups comprised of 1,337 consecutive HCM patients evaluated from 1983 to 2001: 1) surgical myectomy (n = 289); 2) LV outflow obstruction without operation (n = 228); and 3) nonobstructive (n = 820). Mean follow-up duration was 6 +/- 6 years. RESULTS:Including two operative deaths (procedural mortality, 0.8%), 1-, 5-, and 10-year overall survival after myectomy was 98%, 96%, and 83%, respectively, and did not differ from that of the general U.S. population matched for age and gender (p = 0.2) nor from patients with nonobstructive HCM (p = 0.8). Compared to nonoperated obstructive HCM patients, myectomy patients experienced superior survival free from all-cause mortality (98%, 96%, and 83% vs. 90%, 79%, and 61%, respectively; p < 0.001), HCM-related mortality (99%, 98%, and 95% vs. 94%, 89%, and 73%, respectively; p < 0.001), and sudden cardiac death (100%, 99%, and 99% vs. 97%, 93%, and 89%, respectively; p = 0.003). Multivariate analysis showed myectomy to have a strong, independent association with survival (hazard ratio 0.43; p < 0.001). CONCLUSIONS:Surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation. In this retrospective study, septal myectomy seems to reduce mortality risk in severely symptomatic patients with obstructive HCM.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Ommen SR,Maron BJ,Olivotto I,Maron MS,Cecchi F,Betocchi S,Gersh BJ,Ackerman MJ,McCully RB,Dearani JA,Schaff HV,Danielson GK,Tajik AJ,Nishimura RAdoi
10.1016/j.jacc.2005.02.090subject
Has Abstractpub_date
2005-08-02 00:00:00pages
470-6issue
3eissn
0735-1097issn
1558-3597pii
S0735-1097(05)01046-6journal_volume
46pub_type
杂志文章abstract:OBJECTIVES:This review sought to determine whether passive smoking in the workplace has roughly the same association with heart disease as passive smoking at home and to update a previous 1994 review on the effects of home-based passive exposure on the heart. BACKGROUND:To predict the effects of passive smoking at wor...
journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:Our goal was to assess the effect of hypercoagulability on the risk of stroke in patients with aortic plaques. BACKGROUND:Atherosclerotic plaques in the aortic arch are a risk factor for ischemic stroke. Their relationship with blood hypercoagulability, which might enhance their embolic potential and affect...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2008.04.062
更新日期:2008-09-02 00:00:00
abstract::Fifty patients with anteroapical left ventricular aneurysm secondary to prior myocardial infarction underwent aneurysmectomy, at which time endocardial sinus rhythm mapping was performed. Forty patients had a history of recurrent sustained monomorphic ventricular tachycardia, and 10 had an aneurysm but no history of s...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(88)90409-3
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abstract:OBJECTIVES:The goal of this study was to examine the outcomes of percutaneous coronary interventions (PCI) and the predictors for restenosis after cardiac transplantation. BACKGROUND:The role of PCI as definitive therapy for allograft coronary disease (ACD) remains contentious. METHODS:Between January 1, 1990 and Dec...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2004.02.045
更新日期:2004-06-02 00:00:00
abstract:OBJECTIVES:The present study sought to determine whether myocardial contractile abnormalities accompany the development of chest pain in patients with normal coronary angiograms. BACKGROUND:The mechanism of chest pain in patients with angina despite a normal coronary arteriogram is controversial. Although previous stu...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(96)00481-0
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abstract::Ten patients with chronic congestive heart failure were studied to assess the hemodynamic effects and bioavailability of a transdermal nitroglycerin delivery system. Nitrate sensitivity was defined by a prior 20 minute infusion of nitroglycerin, 21 micrograms/min. Five patients with a satisfactory hemodynamic response...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(87)80398-4
更新日期:1987-02-01 00:00:00
abstract::To evaluate the risks of and optimal method for valve dilation in aortic stenosis, balloons of different sizes were used to dilate the normal aortic root in 16 lambs and then stenotic valves in 15 children. In the lambs, inflated balloon to aortic anulus diameter ratios ranged from 0.9 to 1.5. These hearts were examin...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(87)80237-1
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to assess whether transradial access for ST-segment elevation acute coronary syndrome undergoing early invasive treatment is associated with better outcome compared with conventional transfemoral access. BACKGROUND:In patients with acute coronary syndrome, bleeding is a signifi...
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更新日期:2012-12-18 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the safety and efficacy of interventional catheterization performed early after congenital heart surgery. BACKGROUND:Transcatheter interventions performed in the early postoperative period are viewed as high risk. To date, there have been limited published data regar...
journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:We sought to evaluate whether fasting hyperhomocystinemia reduces endothelial function by oxidative stress in normotensive subjects and hypertensive patients. BACKGROUND:Subjects with hyperhomocystinemia have endothelial dysfunction. METHODS:In 23 normotensive subjects and 28 hypertensive patients, classif...
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更新日期:2001-10-01 00:00:00
abstract::The prevention of secondary vascular events is of paramount importance in patients with a history of stroke or transient ischemic attack (TIA). Most cardiologists are aware of the benefits of clopidogrel plus aspirin versus those of other antiplatelet regimens in patients with acute coronary syndrome. Using a represen...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2005.04.058
更新日期:2005-09-06 00:00:00
abstract::Cine nuclear magnetic resonance (NMR) imaging was used to serially measure cardiovascular function in 17 patients with New York Heart Association class II or III heart failure and left ventricular ejection fraction less than or equal to 45% who were treated for 3 months with benazepril hydrochloride, a new angiotensin...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(92)90337-m
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doi:10.1016/j.jacc.2003.07.041
更新日期:2004-01-21 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(96)00126-x
更新日期:1996-07-01 00:00:00
abstract::Intraaortic balloon counterpulsation was instituted in two adult patients whose condition was rapidly deteriorating because of critical decompensated valvular aortic stenosis. The acute hemodynamic effect of counterpulsation in these patients was compared with the effect of counterpulsation in three control patients w...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(85)80399-5
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abstract:OBJECTIVES:The aim of this study was to analyze the relation between anomalies of the heart and aortic arch arteries in near-term rat fetuses exposed to the chemical bis-diamine. BACKGROUND:Bis-diamine is known to induce cardiovascular anomalies. METHODS:Bis-diamine was given orally to normal pregnant rats, and the 6...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(93)90111-d
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journal_title:Journal of the American College of Cardiology
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更新日期:2014-04-01 00:00:00
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更新日期:2015-02-17 00:00:00
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更新日期:2010-10-12 00:00:00
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更新日期:2016-04-12 00:00:00
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更新日期:2019-07-30 00:00:00
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更新日期:2008-01-22 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the role of peripheral presynaptic alpha-2 adrenergic receptors in modulating norepinephrine (NE) release in congestive heart failure (CHF). BACKGROUND:Activation of the sympathetic nervous system is a hallmark of CHF. Clonidine, an imidazoline and adrenergic agonist...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(01)01121-4
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare metabolic risk factors in men with anginal chest pain and a normal or abnormal coronary angiogram with those in healthy men. BACKGROUND:Risk factors for coronary heart disease, including lipoprotein abnormalities, hypertension and adiposity, may be metabolically interlin...
journal_title:Journal of the American College of Cardiology
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更新日期:1994-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2009.02.056
更新日期:2009-06-23 00:00:00
abstract::Six patients referred for echocardiographic evaluation in whom an unusual echocardiographic sign resulted from air within the mediastinum or pericardium are described. Three patients had a pneumomediastinum that occurred after chest trauma and three patients had a pneumopericardium induced during a therapeutic pericar...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80209-5
更新日期:1983-03-01 00:00:00
abstract::Between 25,000 and 75,000 new cases of angina refractory to maximal medical therapy and standard coronary revascularization procedures are diagnosed each year. In addition, heart failure also places an enormous burden on the U.S. health care system, with an estimated economic impact ranging from $20 billion to more th...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2007-10-16 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1998-02-01 00:00:00