PMID- 22093510
OWN - NLM
STAT- MEDLINE
DCOM- 20120126
LR  - 20220408
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 58
IP  - 22
DP  - 2011 Nov 22
TI  - Alcohol septal ablation for the treatment of hypertrophic obstructive 
      cardiomyopathy. A multicenter North American registry.
PG  - 2322-8
LID - 10.1016/j.jacc.2011.06.073 [doi]
AB  - OBJECTIVES: The purpose of the study is to identify the predictors of clinical 
      outcome (mortality and survival without repeat septal reduction procedures) of 
      alcohol septal ablation for the treatment of patients with hypertrophic 
      obstructive cardiomyopathy. BACKGROUND: Alcohol septal ablation is used for 
      treatment of medically refractory hypertrophic obstructive cardiomyopathy 
      patients with severe outflow tract obstruction. The existing literature is 
      limited to single-center results, and predictors of clinical outcome after 
      ablation have not been determined. Registry results can add important data. 
      METHODS: Hypertrophic obstructive cardiomyopathy patients (N = 874) who underwent 
      alcohol septal ablation were enrolled. The majority (64%) had severe obstruction 
      at rest, and the remaining had provocable obstruction. Before ablation, patients 
      had severe dyspnea (New York Heart Association [NYHA] functional class III or IV: 
      78%) and/or severe angina (Canadian Cardiovascular Society angina class III or 
      IV: 43%). RESULTS: Significant improvement (p < 0.01) occurred after ablation 
      (~5% in NYHA functional classes III and IV, and 8 patients in Canadian 
      Cardiovascular Society angina class III). There were 81 deaths, and survival 
      estimates at 1, 5, and 9 years were 97%, 86%, and 74%, respectively. Left 
      anterior descending artery dissections occurred in 8 patients and arrhythmias in 
      133 patients. A lower ejection fraction at baseline, a smaller number of septal 
      arteries injected with ethanol, a larger number of ablation procedures per 
      patient, a higher septal thickness post-ablation, and the use beta-blockers 
      post-ablation predicted mortality. CONCLUSIONS: Variables that predict mortality 
      after ablation, include baseline ejection fraction and NYHA functional class, the 
      number of septal arteries injected with ethanol, post-ablation septal thickness, 
      beta-blocker use, and the number of ablation procedures.
CI  - Copyright (c) 2011 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Nagueh, Sherif F
AU  - Nagueh SF
AD  - Methodist DeBakey Heart and Vascular Center, 6550 Fannin, Houston, TX 77030 USA. 
      snagueh@tmhs.org
FAU - Groves, Bertron M
AU  - Groves BM
FAU - Schwartz, Leonard
AU  - Schwartz L
FAU - Smith, Karen M
AU  - Smith KM
FAU - Wang, Andrew
AU  - Wang A
FAU - Bach, Richard G
AU  - Bach RG
FAU - Nielsen, Christopher
AU  - Nielsen C
FAU - Leya, Ferdinand
AU  - Leya F
FAU - Buergler, John M
AU  - Buergler JM
FAU - Rowe, Steven K
AU  - Rowe SK
FAU - Woo, Anna
AU  - Woo A
FAU - Maldonado, Yolanda Munoz
AU  - Maldonado YM
FAU - Spencer, William H 3rd
AU  - Spencer WH 3rd
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 3K9958V90M (Ethanol)
SB  - IM
CIN - J Am Coll Cardiol. 2011 Nov 22;58(22):2329-31. PMID: 22093511
MH  - Ablation Techniques/adverse effects/*methods/statistics & numerical data
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Angina, Unstable/therapy
MH  - Cardiomyopathy, Hypertrophic/mortality/*therapy
MH  - Coronary Angiography
MH  - Dyspnea/therapy
MH  - Ethanol/*administration & dosage
MH  - Female
MH  - Heart Septum/diagnostic imaging/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - North America
MH  - Registries
MH  - Stroke Volume
MH  - Ultrasonography, Interventional
MH  - Ventricular Outflow Obstruction/mortality/*therapy
EDAT- 2011/11/19 06:00
MHDA- 2012/01/27 06:00
CRDT- 2011/11/19 06:00
PHST- 2011/03/30 00:00 [received]
PHST- 2011/06/08 00:00 [revised]
PHST- 2011/06/14 00:00 [accepted]
PHST- 2011/11/19 06:00 [entrez]
PHST- 2011/11/19 06:00 [pubmed]
PHST- 2012/01/27 06:00 [medline]
AID - S0735-1097(11)04384-1 [pii]
AID - 10.1016/j.jacc.2011.06.073 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2011 Nov 22;58(22):2322-8. doi: 10.1016/j.jacc.2011.06.073.