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Short- and Long-Term Outcome After Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: Experience of a Reference Center

2019-07Journal article Open access
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dc.contributor.authorAguiar Rosa, S
dc.contributor.authorFiarresga, A
dc.contributor.authorGalrinho, A
dc.contributor.authorCacela, D
dc.contributor.authorRamos, R
dc.contributor.authorde Sousa, L
dc.contributor.authorGonçalves, A
dc.contributor.authorBernardes, L
dc.contributor.authorPatrício, L
dc.contributor.authorBranco, LM
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2021-07-14T13:46:26Z
dc.date.available2021-07-14T13:46:26Z
dc.date.issued2019-07
dc.description.abstractIntroduction: 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol (Engl Ed). 2019 Jul;38(7):473-480.pt_PT
dc.identifier.doi10.1016/j.repc.2019.08.003pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3763
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectAblation Techniquespt_PT
dc.subjectCardiac Surgical Procedurespt_PT
dc.subjectCardiomyopathy, Hypertrophicpt_PT
dc.subjectEchocardiographypt_PT
dc.subjectEthanolpt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectTime Factorspt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectVentricular Outflow Obstructionpt_PT
dc.subjectVentricular Septumpt_PT
dc.subjectHSM CARpt_PT
dc.titleShort- and Long-Term Outcome After Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: Experience of a Reference Centerpt_PT
dc.title.alternativeDesfecho a Curto e Longo Prazo Após Ablação Septal Alcoólica na Miocardiopatia Hipertrófica Obstrutiva: Experiência num Centro de Referênciapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage480pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage473pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume38pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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