Alcohol septal ablation (ASA) is an alternative to surgical septal myectomy for treatment of symptomatic HCM. ⢠Because ASA results in an infarct of up to 10% of ...
Preservation of Left Ventricular Systolic Function Following Alcohol Septal Ablation for Symptomatic Hypertrophic Cardiomyopathy Travis J. Moss,
a,b MD ;
Mori J. Krantz, Robert A. Quaife, William H. Sauer, a a,b Ernesto E. Salcedo, MD ; and Joseph L. Schuller, MD
a MD ;
a MD ;
of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; bCardiology Division, Denver Health, Denver, Colorado
Introduction • Hypertrophic cardiomyopathy (HCM) portends an adverse prognosis via: • left ventricular outflow tract (LVOT) obstruction • ventricular dysfunction • sudden death • Alcohol septal ablation (ASA) is an alternative to surgical septal myectomy for treatment of symptomatic HCM • Because ASA results in an infarct of up to 10% of ventricular mass1, concerns have been raised that LV systolic function could decline over time • We evaluated LV systolic function during longitudinal follow-up in a cohort of patients who underwent ASA
Methods Study population • 145 patients with HCM complicated by LVOT obstruction that underwent 167 ASA procedures (2002 to 2011). • Prior to the ASA procedure, all patients had a baseline echocardiogram that demonstrated a normal left ventricular ejection fraction (LVEF > 55%) • Additional echocardiographic indices included: • Interventricular septal wall thickness • Resting and provoked LVOT gradients • Assessment of systolic anterior motion (SAM) of the mitral leaflet • Grading of severity of mitral regurgitation Follow-up • Follow-up through August 2013 occurred annually to assess: • Functional status (New York Heart Association, NYHA, class) • Echocardiographic indices