Alcohol septal ablation in patients with severe septal hypertrophy
ObjectiveThe current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registr...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2020-03, Vol.106 (6), p.462-466 |
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| creator | Veselka, Josef Jensen, Morten Liebregts, Max Cooper, Robert M Januska, Jaroslav Kashtanov, Maksim Dabrowski, Maciej Hansen, Peter Riis Seggewiss, Hubert Hansvenclova, Eva Bundgaard, Henning ten Berg, Jurrien Hilton Stables, Rodney Faber, Lothar |
| description | ObjectiveThe current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement.MethodsWe compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness |
| doi_str_mv | 10.1136/heartjnl-2019-315422 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2283108720</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2283108720</sourcerecordid><originalsourceid>FETCH-LOGICAL-b416t-5dc377dfed15927a0c1b0bb8e252845288a67a4b2cfd29094f5313d784a5c5dc3</originalsourceid><addsrcrecordid>eNqNkMtKxDAUhoMozjj6BiIFN27q5Nqky3HwBgNuFNyFtE1pS28mqTJvb0pnRnAhLkIOh-__OXwAXCJ4ixCJloVWxlVtHWKI4pAgRjE-AnNEIzGu3o_9TBgLI0j4DJxZW0EIaSyiUzAjiHIPkjm4W9VpV3R1YHXvVB2opFau7NqgbIPeT7p1NvgqXeGBT230niu2vTbOdH2xPQcnuaqtvtj9C_D2cP-6fgo3L4_P69UmTCiKXMiylHCe5TpDLMZcwRQlMEmExgwL6p9QEVc0wWme4RjGNGcEkYwLqlg6hhfgZurtTfcxaOtkU9pU17VqdTdYibEgCAqOoUevf6FVN5jWXycxiQiPKYLUU3SiUtNZa3Que1M2ymwlgnJ0LPeO5ehYTo597GpXPiSNzg6hvVQPLCcgaar_VsKfxOHUPyPfs7WXyQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2363794104</pqid></control><display><type>article</type><title>Alcohol septal ablation in patients with severe septal hypertrophy</title><source>PubMed Central</source><creator>Veselka, Josef ; Jensen, Morten ; Liebregts, Max ; Cooper, Robert M ; Januska, Jaroslav ; Kashtanov, Maksim ; Dabrowski, Maciej ; Hansen, Peter Riis ; Seggewiss, Hubert ; Hansvenclova, Eva ; Bundgaard, Henning ; ten Berg, Jurrien ; Hilton Stables, Rodney ; Faber, Lothar</creator><creatorcontrib>Veselka, Josef ; Jensen, Morten ; Liebregts, Max ; Cooper, Robert M ; Januska, Jaroslav ; Kashtanov, Maksim ; Dabrowski, Maciej ; Hansen, Peter Riis ; Seggewiss, Hubert ; Hansvenclova, Eva ; Bundgaard, Henning ; ten Berg, Jurrien ; Hilton Stables, Rodney ; Faber, Lothar</creatorcontrib><description>ObjectiveThe current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement.MethodsWe compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres.ResultsA total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all).ConclusionsThe short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2019-315422</identifier><identifier>PMID: 31471463</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Age ; Alcohol ; alcohol septal ablation ; Cardiac arrhythmia ; Cardiomyopathy ; Heart failure and cardiomyopathies ; hypertrophic cardiomyopathy ; Mortality ; outflow gradient ; Patients ; prognosis ; Software ; Statistical analysis ; survival</subject><ispartof>Heart (British Cardiac Society), 2020-03, Vol.106 (6), p.462-466</ispartof><rights>Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b416t-5dc377dfed15927a0c1b0bb8e252845288a67a4b2cfd29094f5313d784a5c5dc3</citedby><cites>FETCH-LOGICAL-b416t-5dc377dfed15927a0c1b0bb8e252845288a67a4b2cfd29094f5313d784a5c5dc3</cites><orcidid>0000-0003-3597-3155 ; 0000-0002-0467-4817</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31471463$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Veselka, Josef</creatorcontrib><creatorcontrib>Jensen, Morten</creatorcontrib><creatorcontrib>Liebregts, Max</creatorcontrib><creatorcontrib>Cooper, Robert M</creatorcontrib><creatorcontrib>Januska, Jaroslav</creatorcontrib><creatorcontrib>Kashtanov, Maksim</creatorcontrib><creatorcontrib>Dabrowski, Maciej</creatorcontrib><creatorcontrib>Hansen, Peter Riis</creatorcontrib><creatorcontrib>Seggewiss, Hubert</creatorcontrib><creatorcontrib>Hansvenclova, Eva</creatorcontrib><creatorcontrib>Bundgaard, Henning</creatorcontrib><creatorcontrib>ten Berg, Jurrien</creatorcontrib><creatorcontrib>Hilton Stables, Rodney</creatorcontrib><creatorcontrib>Faber, Lothar</creatorcontrib><title>Alcohol septal ablation in patients with severe septal hypertrophy</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><addtitle>Heart</addtitle><description>ObjectiveThe current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement.MethodsWe compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres.ResultsA total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all).ConclusionsThe short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.</description><subject>Age</subject><subject>Alcohol</subject><subject>alcohol septal ablation</subject><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Heart failure and cardiomyopathies</subject><subject>hypertrophic cardiomyopathy</subject><subject>Mortality</subject><subject>outflow gradient</subject><subject>Patients</subject><subject>prognosis</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>survival</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkMtKxDAUhoMozjj6BiIFN27q5Nqky3HwBgNuFNyFtE1pS28mqTJvb0pnRnAhLkIOh-__OXwAXCJ4ixCJloVWxlVtHWKI4pAgRjE-AnNEIzGu3o_9TBgLI0j4DJxZW0EIaSyiUzAjiHIPkjm4W9VpV3R1YHXvVB2opFau7NqgbIPeT7p1NvgqXeGBT230niu2vTbOdH2xPQcnuaqtvtj9C_D2cP-6fgo3L4_P69UmTCiKXMiylHCe5TpDLMZcwRQlMEmExgwL6p9QEVc0wWme4RjGNGcEkYwLqlg6hhfgZurtTfcxaOtkU9pU17VqdTdYibEgCAqOoUevf6FVN5jWXycxiQiPKYLUU3SiUtNZa3Que1M2ymwlgnJ0LPeO5ehYTo597GpXPiSNzg6hvVQPLCcgaar_VsKfxOHUPyPfs7WXyQ</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Veselka, Josef</creator><creator>Jensen, Morten</creator><creator>Liebregts, Max</creator><creator>Cooper, Robert M</creator><creator>Januska, Jaroslav</creator><creator>Kashtanov, Maksim</creator><creator>Dabrowski, Maciej</creator><creator>Hansen, Peter Riis</creator><creator>Seggewiss, Hubert</creator><creator>Hansvenclova, Eva</creator><creator>Bundgaard, Henning</creator><creator>ten Berg, Jurrien</creator><creator>Hilton Stables, Rodney</creator><creator>Faber, Lothar</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group LTD</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3597-3155</orcidid><orcidid>https://orcid.org/0000-0002-0467-4817</orcidid></search><sort><creationdate>20200301</creationdate><title>Alcohol septal ablation in patients with severe septal hypertrophy</title><author>Veselka, Josef ; Jensen, Morten ; Liebregts, Max ; Cooper, Robert M ; Januska, Jaroslav ; Kashtanov, Maksim ; Dabrowski, Maciej ; Hansen, Peter Riis ; Seggewiss, Hubert ; Hansvenclova, Eva ; Bundgaard, Henning ; ten Berg, Jurrien ; Hilton Stables, Rodney ; Faber, Lothar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b416t-5dc377dfed15927a0c1b0bb8e252845288a67a4b2cfd29094f5313d784a5c5dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Alcohol</topic><topic>alcohol septal ablation</topic><topic>Cardiac arrhythmia</topic><topic>Cardiomyopathy</topic><topic>Heart failure and cardiomyopathies</topic><topic>hypertrophic cardiomyopathy</topic><topic>Mortality</topic><topic>outflow gradient</topic><topic>Patients</topic><topic>prognosis</topic><topic>Software</topic><topic>Statistical analysis</topic><topic>survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Veselka, Josef</creatorcontrib><creatorcontrib>Jensen, Morten</creatorcontrib><creatorcontrib>Liebregts, Max</creatorcontrib><creatorcontrib>Cooper, Robert M</creatorcontrib><creatorcontrib>Januska, Jaroslav</creatorcontrib><creatorcontrib>Kashtanov, Maksim</creatorcontrib><creatorcontrib>Dabrowski, Maciej</creatorcontrib><creatorcontrib>Hansen, Peter Riis</creatorcontrib><creatorcontrib>Seggewiss, Hubert</creatorcontrib><creatorcontrib>Hansvenclova, Eva</creatorcontrib><creatorcontrib>Bundgaard, Henning</creatorcontrib><creatorcontrib>ten Berg, Jurrien</creatorcontrib><creatorcontrib>Hilton Stables, Rodney</creatorcontrib><creatorcontrib>Faber, Lothar</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Veselka, Josef</au><au>Jensen, Morten</au><au>Liebregts, Max</au><au>Cooper, Robert M</au><au>Januska, Jaroslav</au><au>Kashtanov, Maksim</au><au>Dabrowski, Maciej</au><au>Hansen, Peter Riis</au><au>Seggewiss, Hubert</au><au>Hansvenclova, Eva</au><au>Bundgaard, Henning</au><au>ten Berg, Jurrien</au><au>Hilton Stables, Rodney</au><au>Faber, Lothar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alcohol septal ablation in patients with severe septal hypertrophy</atitle><jtitle>Heart (British Cardiac Society)</jtitle><stitle>Heart</stitle><addtitle>Heart</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>106</volume><issue>6</issue><spage>462</spage><epage>466</epage><pages>462-466</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>ObjectiveThe current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement.MethodsWe compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres.ResultsA total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all).ConclusionsThe short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>31471463</pmid><doi>10.1136/heartjnl-2019-315422</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-3597-3155</orcidid><orcidid>https://orcid.org/0000-0002-0467-4817</orcidid></addata></record> |
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| subjects | Age Alcohol alcohol septal ablation Cardiac arrhythmia Cardiomyopathy Heart failure and cardiomyopathies hypertrophic cardiomyopathy Mortality outflow gradient Patients prognosis Software Statistical analysis survival |
| title | Alcohol septal ablation in patients with severe septal hypertrophy |
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