Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: one-year follow-up

Lakkis, Nasser; Nagueh, Sherif F.; Dunn, Jon D.; Killip, Donna; Spencer, William H.

doi:10.1016/s0735-1097(00)00767-1

Cited by 132 publications

(95 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9,22 Previous echocardiographic studies have shown ambiguous results with respect to reduction of LV posterior wall thickness. [7][8][9][10][11][23][24][25][26] Tomographic techniques such as electron-beam computed tomography and CMR may be more accurate and reproducible than echocardiographic measurements and LV mass calculations. Electron-beam computed tomography showed septal mass reduction 1 week after ASA and found reduced remote mass at 4 to 6 months of follow-up.…”

Section: Changes In Septal and Remote Myocardial Mass After Asamentioning

confidence: 99%

Early Onset and Progression of Left Ventricular Remodeling After Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy

et al. 2005

View full text Add to dashboard Cite

Background-Alcohol septal ablation (ASA) reduces left ventricular outflow tract (LVOT) pressure gradient in patients with hypertrophic obstructive cardiomyopathy (HOCM), which leads to left ventricular remodeling. We sought to describe the early to midterm changes and modulating factors of the remodeling process using cardiac MRI (CMR). Methods and Results-CMR was performed at baseline and 1 and 6 months after ASA in 29 patients with HOCM (age 52Ϯ16 years). Contrast-enhanced CMR showed no infarct-related hyperenhancement outside the target septal area. Septal mass decreased from 75Ϯ23 g at baseline to 68Ϯ22 and 58Ϯ19 g (PϽ0.001) at 1-and 6-month follow-up, respectively. Remote, nonseptal mass decreased from 141Ϯ41 to 132Ϯ40 and 111Ϯ27 g (PϽ0.001), respectively. Analysis of temporal trends revealed that septal mass reduction was positively associated with contrast-enhanced infarct size and transmural or left-sided septal infarct location at both 1 and 6 months. Remote mass reduction was associated with infarct location at 6 months but not with contrast-enhanced infarct size. By linear regression analysis, percentage remote mass reduction correlated significantly with LVOT gradient reduction at 6-month follow-up (Pϭ0.03). Conclusions-Left

show abstract

Section: Changes In Septal and Remote Myocardial Mass After Asamentioning

confidence: 99%

Early Onset and Progression of Left Ventricular Remodeling After Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy

et al. 2005

View full text Add to dashboard Cite

show abstract

“…In patients suffering from hypertrophic cardiomyopathy exhibiting a LV outflow tract gradient at rest of less than 40 mmHg, who present with advanced symptoms of angina and/or dyspnea [39], SED was performed before and after an application of ethanol. Only patients with induced gradients of more than 60 mmHg were considered candidates for the procedure.…”

Section: New Uses For Echocardiographic Stress Testsmentioning

confidence: 99%

<![CDATA[<b>Stress echocardiography in coronary artery disease</b>]]>

Oliveira¹,

Barreto²,

Silva³

et al. 2004

Braz. j. cardiovasc. surg.

View full text Add to dashboard Cite

Doppler echocardiography is a simple, fast and noninvasive method to identify abnormal regional or global left ventricular function. One could consider this non-invasive method to be the best approach of all imaging techniques.Stress echocardiography techniques are used for the diagnosis, risk stratification, prognosis and the study of myocardial viability in ischemic heart disease. There are many ways of subjecting the heart to stress for echocardiographic studies. For physically fit patients exercise stress testing using a treadmill or bicycle is employed and patients who are unable to exercise undergo pharmacological tests.Although accurate diagnosis and a high prognostic value are achieved with both methods, there are new techniques under study, including the utilization of echocardiographic microbubble contrast for endocardial edge evaluation and for myocardial perfusion studies. Descriptors: Stress. Echocardiography. Coronary disease.Resumo A ecodopplercardiografia é uma metodologia simples, rápida e não invasiva para identificar anormalidades regional e global da função do ventrículo esquerdo, podendo ser considerado o método não invasivo de maior aplicabilidade dentro das técnicas de imagem.A ecocardiografia sob estresse é utilizada para diagnóstico, estratificação de risco, prognóstico e avaliação da viabilidade miocárdica na doença arterial coronariana. Várias são as formas de se submeter o coração ao estresse para o estudo ecocardiográfico. Para indivíduos com capacidade física preservada, utiliza-se o teste com esteira ou bicicleta e para aqueles sem condições de se exercitar, são usados os testes farmacológicos.Apesar da boa acurácia diagnóstica e do valor prognóstico com os dois métodos já referidos, novas técnicas vêm sendo estudadas, como a utilização do contraste ecocardiográfico com microbolhas para avaliação das bordas do endocárdio e o estudo da perfusão miocárdica.Descritores: Estresse. Ecocardiografia. Coronariopatia. 56OLIVEIRA, JLM ET AL -Stress echocardiography in coronary artery disease Rev

show abstract

“…Left ventricular outflow tract (LVOT) obstruction is an important complication of hypertrophic cardiomyopathy, related to symptoms, functional limitations, and prognoses of the patients [1][2][3], and various types of medical and surgical interventions are performed to reduce the pressure gradient in LVOT [4][5][6][7][8][9][10][11][12][13][14][15]. The degree of dynamic obstruction seen in patients with hypertrophic obstructive cardiomyopathy (HOCM) can vary markedly by the physiological changes in preload, contractility, and afterload [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…Transthoracic continuous-wave (CW) Doppler technique has been reported to be feasible to measure the peak velocity in LVOT and to calculate the pressure gradient through the simplified Bernoulli equation [19][20][21]. This method is completely noninvasive and in recent years has become a standard method to quantify the degree of LVOT obstruction and monitor the efficacy of the treatment [8][9][10][11][12][13][14]17].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Left Parasternal Approach for the Continuous-Wave Doppler Measurement of Left Ventricular Outflow Tract Pressure Gradient in Patients With Hypertrophic Cardiomyopathy

et al. 2005

View full text Add to dashboard Cite

Background. The apical approach (ApA) has been usually employed for the continuous-wave Doppler (CWD) measurement of pressure gradient in the left ventricular outflow tract (LVOT) in patients with hypertrophic obstructive cardiomyopathy (HOCM). This study aimed to assess the usefulness of a left parasternal approach (LPA) using the most cranial part of the echo-window for the measurement of the LVOT pressure gradient.Methods. CWD using LPA and ApA was performed in 19 patients with HOCM to measure LVOT peak pressure gradients (PGLPA and PGApA, respectively) and record a signal of mitral regurgitation (MR). The beam incident angles to LVOT flow in LPA ( LPA) and in ApA ( ApA) were measured using color Doppler flow imaging.Results. PGLPA was distinctly greater (>= 10mmHg) than PGApA in 7 patients (37%); they were similar in 6 (32%); and PGLPA was distinctly smaller (<= -10mmHg) than PGApA in 6 (32%). All patients had MR. While all the MR jets in ApA shifted away from the probe, i.e. to the same side of the LVOT flow, 18 of the 19 MR jets shifted to the opposite side of the LVOT flow, when using LPA. Cos LPA was significantly smaller and Cos ApA was significantly greater in the HOCM patients than 10 control subjects (p<0.001 for both). Both PGLPA and PGApA correlated with the invasive pressure gradient (r=0.99 and r=0.97) in 7 patients who underwent invasive study. PGLPA was closer to the invasive pressure gradient than PGApA in 6 patients.Conclusions. LPA provided a more accurate measurement of pressure gradient than ApA in about one third of HOCM patients, probably due to the altered direction of LVOT flow in HOCM. LPA is also useful in distinguishing LVOT flow from MR jet commonly seen in these patients. (J Echocardiogr 2005; 3: 140-147)

show abstract

Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: one-year follow-up

Abstract: Nonsurgical septal reduction therapy is an effective therapy for symptomatic patients with hypertrophic obstructive cardiomyopathy with persistence of the favorable outcome up to one year after the procedure.

Cited by 132 publications

References 19 publications

Early Onset and Progression of Left Ventricular Remodeling After Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy

Early Onset and Progression of Left Ventricular Remodeling After Alcohol Septal Ablation in Hypertrophic Obstructive Cardiomyopathy

<![CDATA[<b>Stress echocardiography in coronary artery disease</b>]]>

Usefulness of Left Parasternal Approach for the Continuous-Wave Doppler Measurement of Left Ventricular Outflow Tract Pressure Gradient in Patients With Hypertrophic Cardiomyopathy

Contact Info

Product

Resources

About