Contemporary Septal Reduction Therapy in Drug-Refractory Hypertrophic Obstructive Cardiomyopathy

Circ J. 2018 Jul 25;82(8):1977-1984. doi: 10.1253/circj.CJ-18-0575. Epub 2018 Jun 15.

Abstract

Hypertrophic cardiomyopathy (HCM) is a complex and relatively common genetic cardiac disease that has been the subject of intense investigation for over 50 years. Most patients with HCM are asymptomatic, but some develop symptoms, often many years after the appearance of electrocardiographic or echocardiographic evidence of left ventricular hypertrophy. Symptoms due to the left ventricular outflow tract obstruction frequently worsen over time, requiring septal reduction therapy (SRT) despite optimal medical therapy. Percutaneous transluminal septal myocardial ablation (PTSMA) and surgical myectomy are collectively known as SRT. In this review, we will focus on the emerging concept and practical implication of SRT and the available evidence on either PTSMA or surgical myectomy in the literature.

Keywords: Heart failure; Hypertrophic cardiomyopathy; Septal reduction therapy.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures / methods*
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Cardiomyopathy, Hypertrophic / therapy*
  • Catheter Ablation
  • Drug Resistance
  • Female
  • Heart Septum / pathology
  • Heart Septum / surgery*
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Risk Factors