W. Mazur et al., Regression of left ventricular hypertrophy after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy, CIRCULATION, 103(11), 2001, pp. 1492-1496
Citations number
17
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Backgromtd-Hypertrophic obstructive cardiomyopathy (HOCM) is characterized
by left ventricular hypertrophy (LVH) in the absence of increased external
load. Recently, nonsurgical septal reduction therapy (NSRT) with intracoron
ary ethanol has been introduced to treat severely symptomatic patients with
outflow tract obstruction. Its long-term effects on LV mass, however, are
unknown.
Methods and Results-The LV size, function, and outflow tract gradient of 26
HOCM patients (53 +/- 15 years old) who underwent NSRT were assessed by ec
hocardiography at baseline and 1 and 2 years after the procedure. LVH was e
valuated by wall thickness of individual myocardial segments, planimetered
myocardial area, and mass. The outflow gradient decreased from 36 +/- 6 mm
Hg before NSRT to 0 +/- 3 mm Hg at 2 years (P<0.001), with patients experie
ncing symptomatic improvement (P<0.05), LV end-diastolic and end-systolic d
imensions increased significantly at both 1 and 2 years (P<0.001). All para
meters of LVH showed evidence of regression. LV mass decreased (301 <plus/m
inus> 78 g at baseline, 223 +/- 5 g at 1 year, and 190 +/- 58 g at 2 years;
P<0.01), with the 2-year reduction in mass related to infarct size and the
acute reduction in outflow tract gradient (r=0.48, P<0.05 and r=0,63, P<0,
01, respectively).
Conclusions-NSRT results in LV remodeling that is characterized by an incre
ase in LV size and a decrease in the extent of LVH.