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Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry

BACKGROUND: The long‐term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long‐term outcomes of mildly symptomatic patients with hypertrophic obstructive...

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Autores principales: Veselka, Josef, Faber, Lothar, Liebregts, Max, Cooper, Robert, Januska, Jaroslav, Krejci, Jan, Bartel, Thomas, Dabrowski, Maciej, Hansen, Peter Riis, Almaas, Vibeke Marie, Seggewiss, Hubert, Horstkotte, Dieter, Adlova, Radka, Bundgaard, Henning, ten Berg, Jurriën, Stables, Rodney Hilton, Jensen, Morten Kvistholm
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524107/
https://www.ncbi.nlm.nih.gov/pubmed/28512112
http://dx.doi.org/10.1161/JAHA.117.005735
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author Veselka, Josef
Faber, Lothar
Liebregts, Max
Cooper, Robert
Januska, Jaroslav
Krejci, Jan
Bartel, Thomas
Dabrowski, Maciej
Hansen, Peter Riis
Almaas, Vibeke Marie
Seggewiss, Hubert
Horstkotte, Dieter
Adlova, Radka
Bundgaard, Henning
ten Berg, Jurriën
Stables, Rodney Hilton
Jensen, Morten Kvistholm
author_facet Veselka, Josef
Faber, Lothar
Liebregts, Max
Cooper, Robert
Januska, Jaroslav
Krejci, Jan
Bartel, Thomas
Dabrowski, Maciej
Hansen, Peter Riis
Almaas, Vibeke Marie
Seggewiss, Hubert
Horstkotte, Dieter
Adlova, Radka
Bundgaard, Henning
ten Berg, Jurriën
Stables, Rodney Hilton
Jensen, Morten Kvistholm
author_sort Veselka, Josef
collection PubMed
description BACKGROUND: The long‐term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long‐term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA. METHODS AND RESULTS: We retrospectively evaluated consecutive patients enrolled in the Euro‐ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre‐ASA. The median (interquartile range) follow‐up was 4.8 (1.7–8.5) years. The clinical outcome was assessed and compared with the age‐ and sex‐matched general population. The 30‐day mortality after ASA was 0.6% and the annual all‐cause mortality rate was 1.7%, which was similar to the age‐ and sex‐matched general population (P=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (P<0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (P<0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively. CONCLUSIONS: Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population.
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spelling pubmed-55241072017-08-02 Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry Veselka, Josef Faber, Lothar Liebregts, Max Cooper, Robert Januska, Jaroslav Krejci, Jan Bartel, Thomas Dabrowski, Maciej Hansen, Peter Riis Almaas, Vibeke Marie Seggewiss, Hubert Horstkotte, Dieter Adlova, Radka Bundgaard, Henning ten Berg, Jurriën Stables, Rodney Hilton Jensen, Morten Kvistholm J Am Heart Assoc Original Research BACKGROUND: The long‐term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long‐term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA. METHODS AND RESULTS: We retrospectively evaluated consecutive patients enrolled in the Euro‐ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre‐ASA. The median (interquartile range) follow‐up was 4.8 (1.7–8.5) years. The clinical outcome was assessed and compared with the age‐ and sex‐matched general population. The 30‐day mortality after ASA was 0.6% and the annual all‐cause mortality rate was 1.7%, which was similar to the age‐ and sex‐matched general population (P=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (P<0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (P<0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively. CONCLUSIONS: Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population. John Wiley and Sons Inc. 2017-05-16 /pmc/articles/PMC5524107/ /pubmed/28512112 http://dx.doi.org/10.1161/JAHA.117.005735 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Veselka, Josef
Faber, Lothar
Liebregts, Max
Cooper, Robert
Januska, Jaroslav
Krejci, Jan
Bartel, Thomas
Dabrowski, Maciej
Hansen, Peter Riis
Almaas, Vibeke Marie
Seggewiss, Hubert
Horstkotte, Dieter
Adlova, Radka
Bundgaard, Henning
ten Berg, Jurriën
Stables, Rodney Hilton
Jensen, Morten Kvistholm
Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry
title Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry
title_full Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry
title_fullStr Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry
title_full_unstemmed Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry
title_short Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation Registry
title_sort outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: a long‐term follow‐up study based on the euro‐alcohol septal ablation registry
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524107/
https://www.ncbi.nlm.nih.gov/pubmed/28512112
http://dx.doi.org/10.1161/JAHA.117.005735
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