Conservative versus invasive treatment in hypertrophic obstructive cardiomyopathy: an echocardiography study

Bratisl Lek Listy. 2016;117(10):562-570. doi: 10.4149/bll_2016_110.

Abstract

Aim and methods: The aim of our study was to compare the development of echocardiographic parameters and functional status of patients with hypertrophic obstructive cardiomyopathy (HOCM) treated conservatively (n = 41) or by alcohol septal ablation (ASA; n = 39).

Results: Left ventricular outflow tract gradient (LVOTG) decreased in the first year by 53.7±36.4 mmHg in ASA group versus 5.5±47.1 mmHg in conservatively treated group (p<0.001), in the third year by 53.1±41.4 mmHg versus 23.9±42.7 mmHg (p = NS) and in the fifth year, the reduction of LVOTG was 52.1±44.5 mmHg in ASA group and 3.0±63.2 mmHg in conservatively treated group (p<0.05).Change in NYHA class in the first year was -1.1±0.4 versus 0.1±0.5, in the third year -1.0±0.6 versus 0.1±0.4 and in the fifth year -0.8±0.5 versus 0.1±0.4 (all p<0.001).

Conclusion: Our results showed for the first time that decline of LVOTG after ASA creates a favorable left ventricle remodeling and leads to significant improvement of functional status of HOCM patients in comparison with conservative treatment (Tab. 3, Fig. 2, Ref. 42).

Keywords: alcohol septal ablation; conservative treatment; hypertrophic obstructive cardiomyopathy; invasive treatment echocardiography..

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiomyopathy, Hypertrophic / diagnostic imaging*
  • Cardiomyopathy, Hypertrophic / surgery*
  • Case-Control Studies
  • Catheter Ablation / methods*
  • Conservative Treatment
  • Echocardiography*
  • Ethanol / administration & dosage*
  • Female
  • Heart Septum / drug effects
  • Heart Septum / surgery*
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ventricular Outflow Obstruction / diagnostic imaging
  • Ventricular Outflow Obstruction / surgery*

Substances

  • Ethanol