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@article{1353910,
author = {Veselka, Josef and Jensen, Morten Kvistholm and Liebregts, Max and Januska, Jaroslav and Krejčí, Jan and Bartel, Thomas and Dabrowski, Maciej and Hansen, Peter Riis and Almaas, Vibeke Marie and Seggewiss, Hubert and Horstkotte, Dieter and Tomasov, Pavol and Adlova, Radka and Bundgaard, Henning and Steggerda, Robbert and Berg, Jurriën ten and Faber, Lothar},
article_location = {Oxford},
article_number = {19},
doi = {http://dx.doi.org/10.1093/eurheartj/ehv693},
keywords = {Alcohol septal ablation; Prognosis; Survival},
language = {eng},
issn = {0195-668X},
journal = {European heart journal},
title = {Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy: results from the Euro-ASA registry},
volume = {37},
year = {2016}
}
TY - JOUR
ID - 1353910
AU - Veselka, Josef - Jensen, Morten Kvistholm - Liebregts, Max - Januska, Jaroslav - Krejčí, Jan - Bartel, Thomas - Dabrowski, Maciej - Hansen, Peter Riis - Almaas, Vibeke Marie - Seggewiss, Hubert - Horstkotte, Dieter - Tomasov, Pavol - Adlova, Radka - Bundgaard, Henning - Steggerda, Robbert - Berg, Jurriën ten - Faber, Lothar
PY - 2016
TI - Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy: results from the Euro-ASA registry
JF - European heart journal
VL - 37
IS - 19
SP - 1517-1523
EP - 1517-1523
PB - Oxford University Press
SN - 0195668X
KW - Alcohol septal ablation
KW - Prognosis
KW - Survival
N2 - Aims The first cases of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) were published two decades ago. Although the outcomes of single-centre and national ASA registries have been published, the long-term survival and clinical outcome of the procedure are still debated. Methods and results We report long-term outcomes from the as yet largest multinational ASA registry (the Euro-ASA registry). A total of 1275 (58+/-14 years, median follow-up 5.7 years) highly symptomatic patients treated with ASA were included. The 30-day post-ASA mortality was 1%. Overall, 171 (13%) patients died during follow-up, corresponding to a post-ASA all-cause mortality rate of 2.42 deaths per 100 patient-years. Survival rates at 1, 5, and 10 years after ASA were 98% (95% CI 96-98%), 89% (95% CI 87-91%), and 77% (95% CI 73-80%), respectively. In multivariable analysis, independent predictors of all-cause mortality were age at ASA (P < 0.01), septum thickness before ASA (P < 0.01), NYHA class before ASA (P = 0.047), and the left ventricular (LV) outflow tract gradient at the last clinical check-up (P = 0.048). Alcohol septal ablation reduced the LV outflow tract gradient from 67 +/- 36 to 16 +/- 21 mmHg (P, 0.01) and NYHA class from 2.9 +/- 0.5 to 1.6 +/- 0.7 (P < 0.01). At the last check-up, 89% of patients reported dyspnoea of NYHA class <= 2, which was independently associated with LV outflow tract gradient (P < 0.01). Conclusions The Euro-ASA registry demonstrated low peri-procedural and long-term mortality after ASA. This intervention provided durable relief of symptoms and a reduction of LV outflow tract obstruction in selected and highly symptomatic patients with obstructive HCM. As the post-procedural obstruction seems to be associated with both worse functional status and prognosis, optimal therapy should be focused on the elimination of LV outflow tract gradient.
ER -
VESELKA, Josef, Morten Kvistholm JENSEN, Max LIEBREGTS, Jaroslav JANUSKA, Jan KREJČÍ, Thomas BARTEL, Maciej DABROWSKI, Peter Riis HANSEN, Vibeke Marie ALMAAS, Hubert SEGGEWISS, Dieter HORSTKOTTE, Pavol TOMASOV, Radka ADLOVA, Henning BUNDGAARD, Robbert STEGGERDA, Jurri$\backslash$''en ten BERG a Lothar FABER. Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy: results from the Euro-ASA registry. \textit{European heart journal}. Oxford: Oxford University Press, 2016, roč.~37, č.~19, s.~1517-1523. ISSN~0195-668X. Dostupné z: https://dx.doi.org/10.1093/eurheartj/ehv693.
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