Travis J. Moss, MDa

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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

Table 1

Figures Baseline 2.00 ± 0.39

Septal thickness (cm)

Post-procedure 1.39 ± 0.47

Change p value -0.61