Biventricular Reverse Remodeling After Successful Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy

Chen, Youzhou; Qiao, Shubin; Hu, Fenghuan; Yuan, Jiansong; Yang, Wei; Cui, Jingang; Zhang, Yan; Zhou, Ying; Zhang, Chang-Lin

doi:10.1016/j.amjcard.2014.11.030

Cited by 13 publications

(6 citation statements)

References 29 publications

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“…In a recent study, Chen and colleagues 4 reported similar results: LV mass, septal mass, and LV remote mass all decreased significantly after percutaneous septal ablation ( p < .001 for all); in line with this, LV end‐diastolic volume and LV end‐diastolic volume index increased significantly at 16‐months follow‐up ( p < .001 for both). Notably they reported also a reversed RV remodeling, evidenced by the reduction of RV mass ( p < .001) and the increase of RV end‐diastolic volume ( p < .001) with an increase in RV ejection fraction during follow‐up (right ventricular ejection fraction pre‐ASA 40 ± 3% versus 46 ± 3% at follow‐up, p < .001).…”

supporting

confidence: 58%

Asymptomatic patients with severe hypertrophic obstructive cardiomyopathy: New perspectives on early percutaneous treatment

Musumeci

Colopi

2021

Cathet Cardio Intervent

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Key Points Hypertrophic cardiomyopathy is the most common genetic cardiac disease. Reverse cardiac remodeling after alcohol septal ablation has been reported in patients with obstructive hypertrophic cardiomyopathy who are symptomatic despite medical therapy. No data exist on early percutaneous therapy to reverse adverse remodeling and improve prognosis in asymptomatic patients with severe left ventricular outflow tract obstruction.

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supporting

confidence: 58%

Asymptomatic patients with severe hypertrophic obstructive cardiomyopathy: New perspectives on early percutaneous treatment

Musumeci

Colopi

2021

Cathet Cardio Intervent

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“…CMRI was performed using a 1.5-T speed clinical scanner (Magnetom Avanto; Siemens Medical Solutions, Erlangen, Germany) within 1 week after admission. Briefly, cine images were obtained in left ventricular two-chamber and four-chamber long-axis, LVOT, and LV short-axis views using true fast imaging by a steady-state precession (TrueFisp) sequence ( 17 ). All CMRI analysis was performed using commercial software (Medis Medical Imaging Systems, Netherlands) by a single experienced observer who was blinded to the patients’ clinical and procedural data.…”

Section: Methodsmentioning

confidence: 99%

B antigen of blood type is associated with worse NYHA classification in male patients with hypertrophic cardiomyopathy

Jiang¹

2018

Anatol J Cardiol

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Objective:ABO blood type is associated with cardiovascular diseases. Several studies have suggested sex-related differences in both hypertrophic cardiomyopathy (HCM) clinical features and ABO blood type. However, few data are available regarding the relationship between ABO blood type and HCM clinical features. We aimed to analyze the relationship between ABO blood type and HCM clinical features, and the potential effects of sex on these relationship.Methods:A total of 549 patients with HCM were enrolled consecutively. Left ventricular outflow tract gradients at rest (LOVTG-R) were measured by echocardiography. Left ventricular end-diastolic dimension, interventricular septum, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular mass (LVM) were assessed using cardiovascular magnetic resonance imaging.Results:Compared with the non-B antigen group, patients with B antigen had significantly higher LOVTG-R and LVEF values, worse New York Heart Association (NYHA) classification, lower left ventricular volume index values, as well as no difference in LVM index values. After adjustments for sex, male patients with B antigen still had higher LOVTG-R values and frequency of NYHA classification III/IV as well as lower LVEDV and LVESV index values. These differences were not present in female patients. Additionally, patients with NYHA classification III/IV had lower LVEDV index values.Conclusion:In males, not females, patients with HCM with blood type B antigens exhibited worse cardiac functional capacity, higher LOVTG-R values, and lower left ventricular volume index values. These relationships are a potential indicator for clinical prevention. We speculate that rehydration is more efficient in relieving symptoms in male patients with HCM with B antigens.

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“…The extent of hypertrophy is inversely associated with regional systolic function and correlates positively with myocardial scarring, even in asymptomatic patients 17,18 . Studies using echocardiography or CMR have clearly demonstrated the reversal of both fibrosis and hypertrophy and related functional impairment in HOCM patients with symptoms after successful PTSMA 3,4,12,13 …”

Section: Discussionmentioning

confidence: 99%

“…PTSMA is proven to be an effective alternative to surgical myectomy in reducing LVOT pressure gradients and relieving drug‐refractory symptoms in patients with hypertrophic obstructive cardiomyopathy (HOCM). PTSMA has also shown to improve geometric and functional parameters (i.e., reverse remodeling) of the myocardium in symptomatic patients as assessed by cardiac magnetic resonance (CMR) imaging and echocardiography 3‐5 . Intervention is indicated in the presence of exertional LVOT pressure gradient >50 mmHg (or >30 mmHg in rest) and drug‐refractory symptoms.…”

Section: Introductionmentioning

confidence: 99%

Reverse remodeling after percutaneous transluminal septal myocardial ablation in severe but asymptomatic LVOT obstruction (RASTA) study: Rationale and design of transcatheter septal reduction in asymptomatic patients with severe hypertrophic obstructive cardiomyopathy

Arslan

Akdim

Berg

2020

Cathet Cardio Intervent

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Objectives The aim of this study is to evaluate the impact of percutaneous transluminal septal myocardial ablation (PTSMA) on remodeling in asymptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) and severe left ventricular outflow tract (LVOT) obstruction. Background Symptoms justify invasive treatment in HOCM patients with LVOT obstruction. Adverse structural and functional changes (remodeling) in the heart occur preceding heart failure and sudden cardiac death. Early invasive treatment in asymptomatic patients may reverse adverse remodeling to the same extent as in symptomatic patients. Methods Reverse remodeling after PTSMA in severe but asymptomatic LVOT obstruction (RASTA) study is a prospective single‐blind randomized trial (http://clinicaltrials.gov number: NCT04230551). Ten asymptomatic HOCM patients with an exertional LVOT gradient ≥50 mmHg (or >30 mmHg in rest) are randomized 1:1 to PTSMA versus conservative therapy, in the absence of mitral valve disease or other indications for cardiac surgery. Five symptomatic (reference group) will undergo PTSMA according to the current guidelines. Results Remodeling is assessed using extensive cardiac imaging with transthoracic echocardiography and late gadolinium enhancement cardiac magnetic resonance at baseline and during follow‐up at 1, 12, and 24 months. Extracellular volume fraction, global, and regional strain analysis, geometry, pressure gradients and changes in four‐dimensional velocity mapping are primary parameters to study (reversal of) adverse remodeling. Conclusions The RASTA study gives insight in cardiac remodeling that may occur in asymptomatic patients after PTSMA. It will provide arguments whether to pursue (or not) a larger trial with clinical endpoints in asymptomatic HOCM patients with severe LVOT obstruction.

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Biventricular Reverse Remodeling After Successful Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy

Cited by 13 publications

References 29 publications

Asymptomatic patients with severe hypertrophic obstructive cardiomyopathy: New perspectives on early percutaneous treatment

Asymptomatic patients with severe hypertrophic obstructive cardiomyopathy: New perspectives on early percutaneous treatment

B antigen of blood type is associated with worse NYHA classification in male patients with hypertrophic cardiomyopathy

Reverse remodeling after percutaneous transluminal septal myocardial ablation in severe but asymptomatic LVOT obstruction (RASTA) study: Rationale and design of transcatheter septal reduction in asymptomatic patients with severe hypertrophic obstructive cardiomyopathy

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