PMID- 19165565
OWN - NLM
STAT- MEDLINE
DCOM- 20090609
LR  - 20211020
IS  - 1615-2573 (Electronic)
IS  - 0910-8327 (Linking)
VI  - 24
IP  - 1
DP  - 2009 Jan
TI  - Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: ultra-low 
      dose of alcohol (1 ml) is still effective.
PG  - 27-31
LID - 10.1007/s00380-008-1083-4 [doi]
AB  - Echo-guided alcohol septal ablation (ASA) is an alternative treatment for highly 
      symptomatic patients with obstructive hypertrophic cardiomyopathy (HOCM). 
      Previous reports suggest that a low dose of alcohol (1.5-2 ml) is as effective as 
      the classic dose (2-4 ml) used in the past. Because a larger infarct might be 
      associated with a potential long-term risk, in this pilot study we wanted to 
      determine whether an ultra-low dose of alcohol (1 ml) would be effective in the 
      mid-term follow-up. Seventy patients (55+/-13 years, range 24-81 years, septum 
      thickness <31 mm) with a highly symptomatic HOCM receiving maximum medical 
      therapy were enrolled. Thirty-five consecutive patients (group I) have been 
      treated with an ultra-low alcohol dose (1.0+/-0.1 ml) and compared with a control 
      group II of 35 patients treated by the same medical team using the classic 
      alcohol dose (2.5+/-0.8 ml) in the past. At 6-month follow-up, both groups of 
      patients improved in dyspnea (2.9+/-0.6 vs 1.5+/-0.5 New York Heart Association 
      [NYHA] class for group I; P<0.01, and 2.5+/-0.7 vs 1.4+/-0.4 NYHA class for group 
      II; P<0.01) and angina (2.1+/-1 vs 0.6+/-0.8 Canadian Cardiovascular Society 
      [CCS] class for group I; P<0.01, and 2.1+/-0.9 vs 0.7+/-0.7 CCS class for group 
      II; P<0.01). There was a significant decrease in left ventricular (LV) ejection 
      fraction (P<0.05), septum thickness (P<0.01), and LV outflow gradient (P<0.01) in 
      both groups of patients. However, there was no significant difference with regard 
      to the extent of symptomatic or echocardiographic changes and complications 
      between both groups. These results suggest that the ultra-low dose of alcohol (1 
      ml) is still effective in the treatment of the majority of HOCM patients without 
      extreme septum hypertrophy (<31 mm).
FAU - Veselka, Josef
AU  - Veselka J
AD  - Department of Cardiology, CardioVascular Center, University Hospital Motol, 
      Vuvalu 84, 150 00 Prague 5, Czech Republic. veselka.josef@seznam.cz
FAU - Zemanek, David
AU  - Zemanek D
FAU - Tomasov, Pavol
AU  - Tomasov P
FAU - Duchonova, Radka
AU  - Duchonova R
FAU - Linhartova, Katerina
AU  - Linhartova K
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090123
PL  - Japan
TA  - Heart Vessels
JT  - Heart and vessels
JID - 8511258
RN  - 3K9958V90M (Ethanol)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Catheterization/*methods
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/physiopathology/*therapy
MH  - Dose-Response Relationship, Drug
MH  - Ethanol/*administration & dosage
MH  - Follow-Up Studies
MH  - Humans
MH  - Injections, Intralesional
MH  - Middle Aged
MH  - Myocardium
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Young Adult
EDAT- 2009/01/24 09:00
MHDA- 2009/06/10 09:00
CRDT- 2009/01/24 09:00
PHST- 2007/12/28 00:00 [received]
PHST- 2008/06/20 00:00 [accepted]
PHST- 2009/01/24 09:00 [entrez]
PHST- 2009/01/24 09:00 [pubmed]
PHST- 2009/06/10 09:00 [medline]
AID - 10.1007/s00380-008-1083-4 [doi]
PST - ppublish
SO  - Heart Vessels. 2009 Jan;24(1):27-31. doi: 10.1007/s00380-008-1083-4. Epub 2009 
      Jan 23.