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Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: one-year follow-up.

Abstract：

OBJECTIVE:The objective of this study is to evaluate the one-year outcome of the first 50 patients who underwent nonsurgical septal reduction for symptomatic hypertrophic obstructive cardiomyopathy at our institution. BACKGROUND:Left ventricular outflow tract obstruction is an important determinant of clinical symptoms in patients with hypertrophic obstructive cardiomyopathy. Nonsurgical septal reduction is a new therapy that has been shown to result in left ventricular outflow tract gradient reduction and resolution of symptoms immediately after the procedure and on midterm follow-up. METHODS:Fifty patients with hypertrophic obstructive cardiomyopathy who underwent nonsurgical septal reduction at our institution and completed 1-year follow-up are described. Complete history, physical examination, two-dimensional echocardiography with Doppler and exercise treadmill testing have been analyzed. RESULTS:The mean age of the study group was 53 +/- 17 years. All patients had refractory symptoms before enrollment. Ninety-four percent had class III or IV New York Heart Association class symptoms at baseline compared to none at 1 year (p < 0.001). The exercise duration increased by 136 s at 1 year (p < 0.021). Only 20% of patients were either receiving beta-blockers or calcium-channel blockers on follow-up. The resting left ventricular outflow tract gradient decreased from 74 +/- 23 mm Hg to 6 +/- 18 mm Hg (p < 0.01) and from 84 +/- 28 mm Hg to 30 +/- 33 mm Hg (p < 0.01) in patients with dobutamine-provoked gradient at one year. These changes are associated with decreased septal thickness and preserved systolic function. CONCLUSION:Nonsurgical septal reduction therapy is an effective therapy for symptomatic patients with hypertrophic obstructive cardiomyopathy with persistence of the favorable outcome up to one year after the procedure.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Lakkis NM,Nagueh SF,Dunn JK,Killip D,Spencer WH 3rd

doi

10.1016/s0735-1097(00)00767-1

subject

Has Abstract

pub_date

2000-09-01 00:00:00

pages

852-5

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(00)00767-1

journal_volume

pub_type

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Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: one-year follow-up.