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Comparison of left ventricular diastolic function in obstructive hypertrophic cardiomyopathy in patients undergoing percutaneous septal alcohol ablation versus surgical myotomy/myectomyBoth percutaneous transcoronary alcohol septal reduction (ASR) and surgical myectomy are effective treatments to relieve left ventricular (LV) outflow tract obstruction in obstructive hypertrophic cardiomyopathy (HC). LV diastolic function was assessed by echocardiography in 57 patients with obstructive HC at baseline and 5 +/- 4 months after ASR (n = 37) or surgical myectomy (n = 20). LV outflow tract pressure gradient decreased from 65 +/- 40 to 23 +/- 21 mm Hg (p <0.01) after treatment. The ratio of the early-to-late peak diastolic LV inflow velocities, and the ratio of the early peak diastolic LV inflow velocity to the lateral mitral annulus early diastolic velocity determined by tissue Doppler imaging significantly decreased after the procedures (1.6 +/- 1.7 vs 1.0 +/- 0.7 and 15 +/- 8 vs 11 +/- 5, respectively), whereas LV inflow propagation velocity significantly increased (60 +/- 24 vs 71 +/- 36 cm/s). Left atrial size decreased from 29 +/- 7 to 25 +/- 6 cm(2) (p <0.05). Patients had a significant improvement in New York Heart Association functional class and in exercise performance. When comparing ASR with myectomy, no difference was found in the degree of change in any parameter of diastolic function. Thus, diastolic function indexes obtained by echocardiography changed after septal reduction interventions in patients with obstructive HC; this change was similar to that after surgical myectomy and ASR.
Document ID
20040087766
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Sitges, Marta
(The Cleveland Clinic Foundation Cleveland, Ohio 44195, United States)
Shiota, Takahiro
Lever, Harry M.
Qin, Jian Xin
Bauer, Fabrice
Drinko, Jeannie K.
Agler, Deborah A.
Martin, Maureen G.
Greenberg, Neil L.
Smedira, Nicholas G.
Lytle, Bruce W.
Tuzcu, E. Murat
Garcia, Mario J.
Thomas, James D.
Date Acquired
August 21, 2013
Publication Date
April 1, 2003
Publication Information
Publication: The American journal of cardiology
Volume: 91
Issue: 7
ISSN: 0002-9149
Subject Category
Life Sciences (General)
Distribution Limits
Public
Copyright
Other
Keywords
Non-NASA Center
NASA Discipline Cardiopulmonary

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