Cargando…
Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy
BACKGROUND: Percutaneous transluminal septal myocardial ablation (PTSMA) and modified Morrow septal myectomy (MMSM) are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy (HCM). This study aimed to determine the clinical outcome of these two strategies....
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850667/ https://www.ncbi.nlm.nih.gov/pubmed/29483385 http://dx.doi.org/10.4103/0366-6999.226075 |
_version_ | 1783306261828206592 |
---|---|
author | Guo, Hong-Chang Li, Jin-Hua Jiang, Teng-Yong Ren, Chang-Wei Dai, Jiang Zhou, Yu-Jie Lai, Yong-Qiang |
author_facet | Guo, Hong-Chang Li, Jin-Hua Jiang, Teng-Yong Ren, Chang-Wei Dai, Jiang Zhou, Yu-Jie Lai, Yong-Qiang |
author_sort | Guo, Hong-Chang |
collection | PubMed |
description | BACKGROUND: Percutaneous transluminal septal myocardial ablation (PTSMA) and modified Morrow septal myectomy (MMSM) are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy (HCM). This study aimed to determine the clinical outcome of these two strategies. METHODS: From January 2011 to January 2015, 226 patients with HCM were treated, 68 by PTSMA and 158 by MMSM. Both ultrasonic cardiograms and heart functional class were recorded before, after operations and in the follow-up. Categorical variables were compared using Chi-square or Fisher's exact tests. Quantitative variables were compared using the paired samples t-test. RESULTS: Interventricular septal thickness was significantly reduced in both groups (21.27 ± 4.43 mm vs. 18.72 ± 4.13 mm for PTSMA, t = 3.469, P < 0.001, and 21.83 ± 5.03 mm vs. 16.57 ± 3.95 mm for MMSM, t = 10.349, P < 0.001, respectively). The left ventricular outflow tract (LVOT) pressure gradient (PG) significantly decreased after the operations in two groups (70.30 ± 44.79 mmHg vs. 39.78 ± 22.07 mmHg for PTSMA, t = 5.041, P < 0.001, and 74.58 ± 45.52 mmHg vs. 13.95 ± 9.94 mmHg for MMSM, t = 16.357, P < 0.001, respectively). Seven patients (10.29%) in the PTSMA group required a repeat operation in the follow-up. Eight (11.76%) patients were evaluated for New York Heart Association (NYHA) III/IV in the PTSMA group, which was significantly more than the five (3.16%) in the same NYHA classes for the MMSM group at follow-up. Less than 15% of patients in the PTSMA group and none of the patients in the MMSM group complained of chest pain during follow-up. CONCLUSIONS: Both strategies can not only relieve LVOT PG but also improve heart function in patients with HCM. However, MMSM might provide a more reliable reduction in gradients compared to PTSMA. |
format | Online Article Text |
id | pubmed-5850667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-58506672018-03-21 Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy Guo, Hong-Chang Li, Jin-Hua Jiang, Teng-Yong Ren, Chang-Wei Dai, Jiang Zhou, Yu-Jie Lai, Yong-Qiang Chin Med J (Engl) Original Article BACKGROUND: Percutaneous transluminal septal myocardial ablation (PTSMA) and modified Morrow septal myectomy (MMSM) are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy (HCM). This study aimed to determine the clinical outcome of these two strategies. METHODS: From January 2011 to January 2015, 226 patients with HCM were treated, 68 by PTSMA and 158 by MMSM. Both ultrasonic cardiograms and heart functional class were recorded before, after operations and in the follow-up. Categorical variables were compared using Chi-square or Fisher's exact tests. Quantitative variables were compared using the paired samples t-test. RESULTS: Interventricular septal thickness was significantly reduced in both groups (21.27 ± 4.43 mm vs. 18.72 ± 4.13 mm for PTSMA, t = 3.469, P < 0.001, and 21.83 ± 5.03 mm vs. 16.57 ± 3.95 mm for MMSM, t = 10.349, P < 0.001, respectively). The left ventricular outflow tract (LVOT) pressure gradient (PG) significantly decreased after the operations in two groups (70.30 ± 44.79 mmHg vs. 39.78 ± 22.07 mmHg for PTSMA, t = 5.041, P < 0.001, and 74.58 ± 45.52 mmHg vs. 13.95 ± 9.94 mmHg for MMSM, t = 16.357, P < 0.001, respectively). Seven patients (10.29%) in the PTSMA group required a repeat operation in the follow-up. Eight (11.76%) patients were evaluated for New York Heart Association (NYHA) III/IV in the PTSMA group, which was significantly more than the five (3.16%) in the same NYHA classes for the MMSM group at follow-up. Less than 15% of patients in the PTSMA group and none of the patients in the MMSM group complained of chest pain during follow-up. CONCLUSIONS: Both strategies can not only relieve LVOT PG but also improve heart function in patients with HCM. However, MMSM might provide a more reliable reduction in gradients compared to PTSMA. Medknow Publications & Media Pvt Ltd 2018-03-05 /pmc/articles/PMC5850667/ /pubmed/29483385 http://dx.doi.org/10.4103/0366-6999.226075 Text en Copyright: © 2018 Chinese Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Guo, Hong-Chang Li, Jin-Hua Jiang, Teng-Yong Ren, Chang-Wei Dai, Jiang Zhou, Yu-Jie Lai, Yong-Qiang Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy |
title | Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy |
title_full | Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy |
title_fullStr | Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy |
title_full_unstemmed | Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy |
title_short | Comparison of Clinical Effects between Percutaneous Transluminal Septal Myocardial Ablation and Modified Morrow Septal Myectomy on Patients with Hypertrophic Cardiomyopathy |
title_sort | comparison of clinical effects between percutaneous transluminal septal myocardial ablation and modified morrow septal myectomy on patients with hypertrophic cardiomyopathy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850667/ https://www.ncbi.nlm.nih.gov/pubmed/29483385 http://dx.doi.org/10.4103/0366-6999.226075 |
work_keys_str_mv | AT guohongchang comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy AT lijinhua comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy AT jiangtengyong comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy AT renchangwei comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy AT daijiang comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy AT zhouyujie comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy AT laiyongqiang comparisonofclinicaleffectsbetweenpercutaneoustransluminalseptalmyocardialablationandmodifiedmorrowseptalmyectomyonpatientswithhypertrophiccardiomyopathy |