Risk marker profiles in patients treated with percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy

Burghardt, Amelie; Buuren, Frank van; Dimitriadis, Zisis; Grübbel, Tim; Seggewiß, Hubert; Scholtz, Smita; Horstkotte, Dieter; Faber, Lothar

doi:10.1007/s00392-018-1209-3

Cited by 7 publications

(3 citation statements)

References 35 publications

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“…Second, the gold standard procedure, percutaneous transluminal septal myocardial ablation, was not taken into account in this study. Although 10% to 20% 25,26 of patients may have atrioventricular block after receiving the treatment, which may affect the assessment by 2D‐STI, it does not preclude the feasibility of assessment in the other 80% to 90%. However, to our knowledge, the same conclusion may be reached regarding the patients receiving percutaneous transluminal septal myocardial ablation, and we hope to validate it in future studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of 2D speckle tracking imaging in evaluating the effect of percutaneous intramyocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy

Qian

Zhou

Liu

et al. 2021

J of Clinical Ultrasound

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Purpose To explore the short‐term changes after percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) in patients with hypertrophic obstructive cardiomyopathy (HOCM), using quantitative analysis of two‐dimensional speckle tracking imaging (2D‐STI). Methods This prospective self‐controlled study included 30 HOCM patients treated with PIMSRA. The study for each patient spanned over at least 1 year. Interventricular septal thickness and the left ventricular outflow tract peak pressure gradient (LVOT‐PG) were measured through echocardiography, and 2D‐STI was used to evaluate the left ventricular (LV) systolic function and synchrony. Cardiac function was assessed using the New York Heart Association's (NYHA) functional classification for cardiac disease, and through the serum levels of cardiac troponin I (cTnI) and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP). Biomarkers procollagen type I carboxy‐terminal propeptide (PICP) and matrix metalloproteinases‐2 (MMP‐2) were detected for noninvasive assessment of myocardial fibrosis. Results The patients' interventricular septal thickness, LVOT‐PG, NYHA class, and plasma PICP and MMP‐2 levels at the first month postoperatively were significantly lower than before operation (all P < .05). The 2D‐STI quantitative variables of LV systolic function and synchrony improved significantly (all P < .05). They improved further 1 year postoperatively (P < .01 or P < .001). Serum cTnI and NT‐proBNP levels increased 1 month postoperatively, but significantly decreased 1 year postoperatively (both P < .05). Pearson or Spearman correlation analysis showed that the improvement of interventricular septal thickness, LVOT‐PG, NYHA class, and the levels of cTnI, NT‐proBNP, PICP and MMP‐2, were in positive correlation with the restoration of LV systolic function and synchrony (P < .01 or P < .001). Conclusion The changes in 2D‐STI quantitative variables related to LV systolic function and synchrony are closely correlated with the improvement of cardiac function in HOCM patients after PIMSRA. These 2D‐STI variables can serve for objective, accurate, and noninvasive evaluation of the HOCM treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical value of 2D speckle tracking imaging in evaluating the effect of percutaneous intramyocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy

Qian

Zhou

Liu

et al. 2021

J of Clinical Ultrasound

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“…Therefore, these high-risk patients should be considered candidates for ICD implantation and relief of LV outflow obstruction to decrease the overall risk burden 6 7 12. However, there is an ongoing debate as to whether ASA-induced scar of the basal IVS is an appropriate therapy for these patients 28–30. There are at least two uncertainties concerning ASA that should be considered.…”

Section: Discussionmentioning

confidence: 99%

Alcohol septal ablation in patients with severe septal hypertrophy

Veselka

Jensen

Liebregts

et al. 2019

Heart

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ObjectiveThe current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement.MethodsWe compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres.ResultsA total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all).ConclusionsThe short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.

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“…Additionally, most patients with CKD suffer from malignant arterial hypertension due to inadequate volume control, which is a direct cause of left ventricular hypertrophy (LVH) [ 7 ]. LVH is associated with an increased risk of sudden cardiac arrest (SCA), affecting more than 70% of patients receiving RRT [ 6 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Effect of Underlying Chronic Kidney Disease and Renal Replacement Therapy on the Outcome of Patients after Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study

et al. 2022

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Background and Objectives: This study assessed the prognostic value of underlying chronic kidney disease (CKD) and renal replacement therapy (RRT) on the clinical outcomes from out-of-hospital cardiac arrest (OHCA). Materials and Methods: This retrospective study was conducted utilizing the population-based OHCA data of South Korea between 2008 and 2018. Adult (>18 years) OHCA patients with a medical cause of cardiac arrest were included and classified into three categories based on the underlying CKD and RRT: (1) non-CKD group; (2) CKD without RRT group; and (3) CKD with RRT group. A total of 13,682 eligible patients were included (non-CKD, 9863; CKD without RRT, 1778; CKD with RRT, 2041). From the three comparison subgroups, data with propensity score matching were extracted. The influence of CKD and RRT on patient outcomes was assessed using propensity score matching and multivariate logistic regression analyses. The primary outcome was survival at hospital discharge and the secondary outcome was a good neurological outcome at hospital discharge. Results: The two CKD groups (CKD without RRT and CKD with RRT) showed no significant difference in survival at hospital discharge compared with the non-CKD group (CKD without RRT vs. non-CKD, p > 0.05; CKD with RRT vs. non-CKD, p > 0.05). The non-CKD group had a higher chance of having good neurological outcomes than the CKD groups (non-CKD vs. CKD without RRT, p < 0.05; non-CKD vs. CKD with RRT, p < 0.05) whereas there was no significant difference between the two CKD groups (CKD without RRT vs. CKD with RRT, p > 0.05). Conclusions: Compared with patients without CKD, the underlying cause of CKD—regardless of RRT—may be linked to poor neurological outcomes. Underlying CKD and RRT had no effect on the survival at hospital discharge.

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Risk marker profiles in patients treated with percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy

Abstract: Our findings suggest that the risk profile after septal ablation may differ from that of HOCM patients without an outflow desobliteration.

Cited by 7 publications

References 35 publications

Clinical value of 2D speckle tracking imaging in evaluating the effect of percutaneous intramyocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy

Clinical value of 2D speckle tracking imaging in evaluating the effect of percutaneous intramyocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy

Alcohol septal ablation in patients with severe septal hypertrophy

Prognostic Effect of Underlying Chronic Kidney Disease and Renal Replacement Therapy on the Outcome of Patients after Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study

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