Vol 60, No 2 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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The biphasic course of changes of left ventricular outflow gradient after alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Josef Veselka, Radka Duchonová, Srka Prochzkov, Ingrid Homolov, Jana Plenckov, David Zem nek, Zuzana Pernisov, David Tesar
Kardiol Pol 2004;60(2):136-136.
Vol 60, No 2 (2004)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background and aim: Alcohol septal ablation (PTSMA) decreases left ventricular outflow gradient (LVOG) and relieves symptoms in patients with hypertrophic obstructive cardiomyopathy (HOCM). The time course of early changes of LVOG has not been clearly determined up to now.
Methods: Doppler echocardiography was used to determine the maximal LVOG. Thirty-nine consecutive patients (24 women; age 55±14) were examined at baseline, immediately after the procedure, and 3-5 days, 3 weeks and 3 months thereafter.
Results: The baseline LVOG decreased immediately after PTSMA from 73&#177;49 mmHg to 13&#177;16 mmHg (p<0.01). During the hospital stay (postprocedural period) LVOG increased from 13&#177;16 to 37&#177;35 mmHg (p<0.01). All the patients were discharged 5-10 days after the procedure. At three-week examination LVOG decreased from 37&#177;35 to 25&#177;12 mmHg (p<0.01). Three-month survival was 97%. One patient died suddenly one month after PTSMA. At three-month examination LVOG decreased from 25&#177;12 to 17&#177;14 mmHg (NS). All the patients reported an improvement in symptoms at follow-up.
Conclusions: The immediate decrease of LVOG after PTSMA procedure caused by myocardial necrosis and stunning, was followed by a significant LVOG increase during the early postprocedural period and continuous LVOG decrease at the short-term follow-up.

Abstract

Background and aim: Alcohol septal ablation (PTSMA) decreases left ventricular outflow gradient (LVOG) and relieves symptoms in patients with hypertrophic obstructive cardiomyopathy (HOCM). The time course of early changes of LVOG has not been clearly determined up to now.
Methods: Doppler echocardiography was used to determine the maximal LVOG. Thirty-nine consecutive patients (24 women; age 55&#177;14) were examined at baseline, immediately after the procedure, and 3-5 days, 3 weeks and 3 months thereafter.
Results: The baseline LVOG decreased immediately after PTSMA from 73&#177;49 mmHg to 13&#177;16 mmHg (p<0.01). During the hospital stay (postprocedural period) LVOG increased from 13&#177;16 to 37&#177;35 mmHg (p<0.01). All the patients were discharged 5-10 days after the procedure. At three-week examination LVOG decreased from 37&#177;35 to 25&#177;12 mmHg (p<0.01). Three-month survival was 97%. One patient died suddenly one month after PTSMA. At three-month examination LVOG decreased from 25&#177;12 to 17&#177;14 mmHg (NS). All the patients reported an improvement in symptoms at follow-up.
Conclusions: The immediate decrease of LVOG after PTSMA procedure caused by myocardial necrosis and stunning, was followed by a significant LVOG increase during the early postprocedural period and continuous LVOG decrease at the short-term follow-up.
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Keywords

hypertrophic obstructive cardiomyopathy - ablation - alcohol - gradient

About this article
Title

The biphasic course of changes of left ventricular outflow gradient after alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 60, No 2 (2004)

Pages

136-136

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2004;60(2):136-136.

Keywords

hypertrophic obstructive cardiomyopathy - ablation - alcohol - gradient

Authors

Josef Veselka
Radka Duchonová
Srka Prochzkov
Ingrid Homolov
Jana Plenckov
David Zem nek
Zuzana Pernisov
David Tesar

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