Význam periprocedurálního poklesu tlakového gradientu ve výtokovém traktu levé komory po alkoholové septální ablaci u pacientů s hypertrofickou obstrukční kardiomyopatií
| Title in English | Significance of periprocedural decrease in left ventricular outflow tract gradient after alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy |
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| Authors | |
| Year of publication | 2016 |
| Type | Article in Periodical |
| Magazine / Source | Kardiologická revue - Interní medicína |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | hypertrophic obstructive cardiomyopathy; alcohol septal ablation; echocardiography |
| Description | Introduction: Alcohol septal ablation (ASA) is one of the non-pharmacological treatment options for highly symptomatic patients with hypertrophic obstructive cardiomyopathy resistant to pharmacotherapy. Objective: The aim of our study was to evaluate the relationship between an intraprocedural decrease in the left ventricular outflow tract gradient (LVOTG) measured invasively during the procedure and the development of clinical and echocardiographic parameters in the early period (3 months) and the later period (12 months) after ASA. Patients and methods: Our study included 32 patients, mean age 58.6 ± 12.6 years, who underwent ASA for pharmacoresistant limiting symptoms. The investigated parameters were the following: resting LVOTG, thickness of the interventricular septum and left ventricular posterior wall, left ventricular end-diastolic diameter, left atrium size, left ventricular ejection fraction and NYHA class; evaluated in the 3rd and 12th month after the procedure. Results: Intraprocedural LVOTG (iLVOTG) change correlated with a change of echocardiographically measured LVOTG during a 0-3-month period (r = 0.56; p < 0.001) and 0-12-month period (r = 0.40; p < 0.05). Correlation between iLVOTG change and change of other echocardiographic parameters and functional status was not found, with the exception of an end-diastolic diameter change in a 0-12-month period (r = -0.39; p < 0.05) and 3-12-month period (r = -0.41; p < 0.05). Conclusion: Invasively evaluated intraprocedural decline of LVOTG predicts the later development in LVOTG. The value of LVOTG in the 3rd month can be used to estimate the long-term eff ect of ASA |
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