Outcomes of Alcohol Septal Ablation in Younger Patients With
Obstructive Hypertrophic Cardiomyopathy

J 2017

Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy

LIEBREGTS, Max, Lothar FABER, Morten K. JENSEN, Pieter A. VRIESENDORP, Jaroslav JANUSKA et. al.

Basic information

Original name

Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy

Authors

LIEBREGTS, Max (528 Netherlands), Lothar FABER (276 Germany), Morten K. JENSEN (208 Denmark), Pieter A. VRIESENDORP (528 Netherlands), Jaroslav JANUSKA (203 Czech Republic), Jan KREJČÍ (203 Czech Republic, guarantor, belonging to the institution), Peter R. HANSEN (208 Denmark), Hubert SEGGEWISS (276 Germany), Dieter HORSTKOTTE (276 Germany), Radka ADLOVA (203 Czech Republic), Henning BUNDGAARD (208 Denmark), Jurriën M. ten BERG (528 Netherlands) and Josef VESELKA (203 Czech Republic)

Edition

JACC - Cardiovascular Interventions, New York, Elsevier Science Inc. 2017, 1936-8798

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 9.881

RIV identification code

RIV/00216224:14110/17:00097296

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.jcin.2017.03.030

UT WoS

000402974900013

Keywords in English

alcohol septal ablation; hypertrophic cardiomyopathy; septal reduction therapy

Abstract

V originále

OBJECTIVES The aim of this study was to describe the safety and outcomes of alcohol septal ablation (ASA) in younger patients with obstructive hypertrophic cardiomyopathy. BACKGROUND The American College of Cardiology Foundation/American Heart Association guidelines reserve ASA for older patients and patients with serious comorbidities. Data on long-term age-specific outcomes after ASA are scarce. METHODS A total of 1,197 patients (mean age 58 +/- 14 years) underwent ASA for obstructive hypertrophic cardiomyopathy. Patients were divided into young (<= 50 years), middle-age (51 to 64 years), and older (>= 65 years) groups. RESULTS Thirty-day mortality and pacemaker implantation rates were lower in young compared with older patients (0.3% vs. 2%[p = 0.03] and 8% vs. 16%[p < 0.001], respectively). Ninety-five percent of young patients were in New York Heart Association functional class I or II at last follow-up. During a mean follow-up period of 5.4 +/- 4.2 years, 165 patients (14%) died. Annual mortality rates of young, middle-age, and older patients were 1%, 2%, and 5%, respectively (p < 0.01). Annual adverse arrhythmic event rates were similar in the 3 age groups at about 1%(p = 0.90). Independent predictors of mortality in young patients were age, female sex, and residual left ventricular outflow tract gradient. Additionally, young patients treated with >= 2.5 ml alcohol had a higher all-cause mortality rate (0.6% vs. 1.4% per year in patients treated with < 2.5 ml, p = 0.03). CONCLUSIONS ASA in younger patients with obstructive hypertrophic cardiomyopathy was safe and effective for relief of symptoms at long-term follow-up. The authors propose that the indication for ASA can be broadened to younger patients. (J Am Coll Cardiol Intv 2017;10:1134-43) (C) 2017 by the American College of Cardiology Foundation.

Citovat

LIEBREGTS, Max, Lothar FABER, Morten K. JENSEN, Pieter A. VRIESENDORP, Jaroslav JANUSKA, Jan KREJČÍ, Peter R. HANSEN, Hubert SEGGEWISS, Dieter HORSTKOTTE, Radka ADLOVA, Henning BUNDGAARD, Jurriën M. ten BERG and Josef VESELKA. Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy. JACC - Cardiovascular Interventions. New York: Elsevier Science Inc., 2017, vol. 10, No 11, p. 1135-1143. ISSN 1936-8798. Available from: https://dx.doi.org/10.1016/j.jcin.2017.03.030.

@article{1386644,
   author = {Liebregts, Max and Faber, Lothar and Jensen, Morten K. and Vriesendorp, Pieter A. and Januska, Jaroslav and Krejčí, Jan and Hansen, Peter R. and Seggewiss, Hubert and Horstkotte, Dieter and Adlova, Radka and Bundgaard, Henning and Berg, Jurriën M. ten and Veselka, Josef},
   article_location = {New York},
   article_number = {11},
   doi = {http://dx.doi.org/10.1016/j.jcin.2017.03.030},
   keywords = {alcohol septal ablation; hypertrophic cardiomyopathy; septal reduction therapy},
   language = {eng},
   issn = {1936-8798},
   journal = {JACC - Cardiovascular Interventions},
   title = {Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy},
   volume = {10},
   year = {2017}
}

TY  - JOUR
ID  - 1386644
AU  - Liebregts, Max - Faber, Lothar - Jensen, Morten K. - Vriesendorp, Pieter A. - Januska, Jaroslav - Krejčí, Jan - Hansen, Peter R. - Seggewiss, Hubert - Horstkotte, Dieter - Adlova, Radka - Bundgaard, Henning - Berg, Jurriën M. ten - Veselka, Josef
PY  - 2017
TI  - Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy
JF  - JACC - Cardiovascular Interventions
VL  - 10
IS  - 11
SP  - 1135-1143
EP  - 1135-1143
PB  - Elsevier Science Inc.
SN  - 19368798
KW  - alcohol septal ablation
KW  - hypertrophic cardiomyopathy
KW  - septal reduction therapy
N2  - OBJECTIVES The aim of this study was to describe the safety and outcomes of alcohol septal ablation (ASA) in younger patients with obstructive hypertrophic cardiomyopathy. BACKGROUND The American College of Cardiology Foundation/American Heart Association guidelines reserve ASA for older patients and patients with serious comorbidities. Data on long-term age-specific outcomes after ASA are scarce. METHODS A total of 1,197 patients (mean age 58 +/- 14 years) underwent ASA for obstructive hypertrophic cardiomyopathy. Patients were divided into young (<= 50 years), middle-age (51 to 64 years), and older (>= 65 years) groups. RESULTS Thirty-day mortality and pacemaker implantation rates were lower in young compared with older patients (0.3% vs. 2%[p = 0.03] and 8% vs. 16%[p < 0.001], respectively). Ninety-five percent of young patients were in New York Heart Association functional class I or II at last follow-up. During a mean follow-up period of 5.4 +/- 4.2 years, 165 patients (14%) died. Annual mortality rates of young, middle-age, and older patients were 1%, 2%, and 5%, respectively (p < 0.01). Annual adverse arrhythmic event rates were similar in the 3 age groups at about 1%(p = 0.90). Independent predictors of mortality in young patients were age, female sex, and residual left ventricular outflow tract gradient. Additionally, young patients treated with >= 2.5 ml alcohol had a higher all-cause mortality rate (0.6% vs. 1.4% per year in patients treated with < 2.5 ml, p = 0.03). CONCLUSIONS ASA in younger patients with obstructive hypertrophic cardiomyopathy was safe and effective for relief of symptoms at long-term follow-up. The authors propose that the indication for ASA can be broadened to younger patients. (J Am Coll Cardiol Intv 2017;10:1134-43) (C) 2017 by the American College of Cardiology Foundation.
ER  -

LIEBREGTS, Max, Lothar FABER, Morten K. JENSEN, Pieter A. VRIESENDORP, Jaroslav JANUSKA, Jan KREJČÍ, Peter R. HANSEN, Hubert SEGGEWISS, Dieter HORSTKOTTE, Radka ADLOVA, Henning BUNDGAARD, Jurri$\backslash$''en M. ten BERG and Josef VESELKA. Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy. \textit{JACC - Cardiovascular Interventions}. New York: Elsevier Science Inc., 2017, vol.~10, No~11, p.~1135-1143. ISSN~1936-8798. Available from: https://dx.doi.org/10.1016/j.jcin.2017.03.030.

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