Abstract 15519: Baseline Septal Thickness Does Not Predict One-Year Echocardiographic and Functional Outcomes after Alcohol Septal Ablation for Hypertrophic Cardiomyopathy
Introduction: There is a paucity of data regarding the impact of septal thickness on outcomes after alcohol septal ablation (ASA) for medically refractory hypertrophic cardiomyopathy (HCM) with obstruction. We assessed the hypothesis that baseline septal thickness would impact one-year echocardiographic and functional outcomes following ASA.
Methods: We retrospectively analyzed 156 consecutive patients that underwent ASA at our institution between October 1999 and December 2007 who had echocardiographic images available for review at baseline and one year. These patients were divided into 3 groups based on baseline septal thickness; Group A: <2cm (n=75), B: 2-2.49cm (n=60), and C: ≥2.5cm (n=21). Left ventricular outflow tract (LVOT) gradients and New York Heart Association (NYHA) class were recorded at 1 year or at the time of repeat septal reduction therapy. The rate of repeat septal reduction therapy within one year was also recorded.
Results: Each group had a similar and significant reduction in LVOT gradient after ASA (see Figure 1A). There was also a significant reduction in NYHA class in each group after ASA (see Figure 1B). The magnitude of NYHA class reduction between groups was similar (-1.26 vs. -1.44 vs. -1.29 for groups A, B, and C, respectively; p=NS). A total of 17 patients underwent repeat ASA and 1 patient underwent myectomy. There was no significant difference in the rate of repeat septal reduction therapy between the 3 groups (13.3%, 11.7%, and 4.8%, respectively; p=NS).
Conclusion: Patients undergoing ASA for medically refractory HCM had similar and significant improvements in LVOT gradients and NYHA class regardless of baseline septal thickness with no significant difference in the rate of repeat septal reduction therapy at one year.
- © 2012 by American Heart Association, Inc.