Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy

Morten K Jensen; Linda Jacobsson; Vibeke Marie Almaas; Frank van Buuren; Peter R Hansen; Thomas Fritz Hansen; Svend Aakhus; Maria J Eriksson; Henning Bundgård; Lothar Faber

doi:10.1161/circinterventions.115.003214

Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy

Morten K Jensen, Linda Jacobsson, Vibeke Marie Almaas, Frank van Buuren, Peter R Hansen, Thomas Fritz Hansen, Svend Aakhus, Maria J Eriksson, Henning Bundgård, Lothar Faber

6 Citationer (Scopus)

Abstract

Background - We assessed the influence of interventricular septal thickness (IVSd) on the clinical outcome and survival after alcohol septal ablation (ASA) in patient with hypertrophic cardiomyopathy. Methods and Results - We analyzed 531 patients with hypertrophic cardiomyopathy (age: 56±14 years, men 55%) treated with ASA. Survival status was obtained 7.9±4.0 years after ASA. Baseline IVSd was inversely associated with survival (hazard ratio [HR] for 1 mm increment, 1.13; confidence interval, 1.05-1.21; P<0.001) after adjustment for age, sex, body mass index, and ASA-performing center. Compared with patients with baseline IVSd <20 mm, patients with baseline IVSd ≥25 mm had reduced survival (HR, 5.0; CI, 2.1-12), whereas patients with baseline IVSd 20 to 24 mm had similar survival (HR, 1.4; CI, 0.7-2.8). Baseline IVSd was not correlated with New York Heart Association class, Canadian Cardiology Society class, or syncope. Clinical outcome was assessed 0.6±0.6 years after ASA. IVSd was not related to left ventricular outflow tract gradient reduction at rest (P=0.883) or during Valsalva maneuver (P=0.885). The proportion of patients in New York Heart Association class 3 to 4 was reduced from 86% to 10%; in Canadian Cardiology Society class 3 to 4 from 26% to 2%; and with syncope from 25% to 2%. There were no correlations between baseline IVSd and New York Heart Association class (P=0.067), Canadian Cardiology Society class (P=0.106), or syncope (P=0.426) after ASA. Conclusions - ASA had equal effects on left ventricular outflow tract gradients and symptoms throughout the spectrum of septal hypertrophy. Severe septal hypertrophy before ASA remained a marker of reduced survival after ASA with a 5-fold increased risk of all-cause mortality in patients with baseline IVSd >25 mm compared with patients with baseline IVSd <20 mm.

Originalsprog	Engelsk
Artikelnummer	e003214
Tidsskrift	Circulation: Cardiovascular Interventions
Vol/bind	9
Udgave nummer	6
Antal sider	10
ISSN	1941-7640
DOI	https://doi.org/10.1161/circinterventions.115.003214
Status	Udgivet - 1 jun. 2016

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10.1161/circinterventions.115.003214

CIRCINTERVENTIONS.115.003214Forlagets udgivne version, 350 KB

Citationsformater

Jensen, M. K., Jacobsson, L., Almaas, V. M., van Buuren, F., Hansen, P. R., Hansen, T. F., Aakhus, S., Eriksson, M. J., Bundgård, H., & Faber, L. (2016). Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy. Circulation: Cardiovascular Interventions, 9(6), [e003214]. https://doi.org/10.1161/circinterventions.115.003214

@article{d483bdd84813421da3460d4247a67107,

title = "Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy",

abstract = "Background - We assessed the influence of interventricular septal thickness (IVSd) on the clinical outcome and survival after alcohol septal ablation (ASA) in patient with hypertrophic cardiomyopathy. Methods and Results - We analyzed 531 patients with hypertrophic cardiomyopathy (age: 56±14 years, men 55%) treated with ASA. Survival status was obtained 7.9±4.0 years after ASA. Baseline IVSd was inversely associated with survival (hazard ratio [HR] for 1 mm increment, 1.13; confidence interval, 1.05-1.21; P<0.001) after adjustment for age, sex, body mass index, and ASA-performing center. Compared with patients with baseline IVSd <20 mm, patients with baseline IVSd ≥25 mm had reduced survival (HR, 5.0; CI, 2.1-12), whereas patients with baseline IVSd 20 to 24 mm had similar survival (HR, 1.4; CI, 0.7-2.8). Baseline IVSd was not correlated with New York Heart Association class, Canadian Cardiology Society class, or syncope. Clinical outcome was assessed 0.6±0.6 years after ASA. IVSd was not related to left ventricular outflow tract gradient reduction at rest (P=0.883) or during Valsalva maneuver (P=0.885). The proportion of patients in New York Heart Association class 3 to 4 was reduced from 86% to 10%; in Canadian Cardiology Society class 3 to 4 from 26% to 2%; and with syncope from 25% to 2%. There were no correlations between baseline IVSd and New York Heart Association class (P=0.067), Canadian Cardiology Society class (P=0.106), or syncope (P=0.426) after ASA. Conclusions - ASA had equal effects on left ventricular outflow tract gradients and symptoms throughout the spectrum of septal hypertrophy. Severe septal hypertrophy before ASA remained a marker of reduced survival after ASA with a 5-fold increased risk of all-cause mortality in patients with baseline IVSd >25 mm compared with patients with baseline IVSd <20 mm.",

author = "Jensen, {Morten K} and Linda Jacobsson and Almaas, {Vibeke Marie} and {van Buuren}, Frank and Hansen, {Peter R} and Hansen, {Thomas Fritz} and Svend Aakhus and Eriksson, {Maria J} and Henning Bundg{\aa}rd and Lothar Faber",

note = "{\textcopyright} 2016 American Heart Association, Inc.",

year = "2016",

month = jun,

day = "1",

doi = "10.1161/circinterventions.115.003214",

language = "English",

volume = "9",

journal = "Circulation: Cardiovascular Interventions",

issn = "1941-7640",

publisher = "Lippincott Williams & Wilkins",

number = "6",

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TY - JOUR

T1 - Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy

AU - Jensen, Morten K

AU - Jacobsson, Linda

AU - Almaas, Vibeke Marie

AU - van Buuren, Frank

AU - Hansen, Peter R

AU - Hansen, Thomas Fritz

AU - Aakhus, Svend

AU - Eriksson, Maria J

AU - Bundgård, Henning

AU - Faber, Lothar

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Background - We assessed the influence of interventricular septal thickness (IVSd) on the clinical outcome and survival after alcohol septal ablation (ASA) in patient with hypertrophic cardiomyopathy. Methods and Results - We analyzed 531 patients with hypertrophic cardiomyopathy (age: 56±14 years, men 55%) treated with ASA. Survival status was obtained 7.9±4.0 years after ASA. Baseline IVSd was inversely associated with survival (hazard ratio [HR] for 1 mm increment, 1.13; confidence interval, 1.05-1.21; P<0.001) after adjustment for age, sex, body mass index, and ASA-performing center. Compared with patients with baseline IVSd <20 mm, patients with baseline IVSd ≥25 mm had reduced survival (HR, 5.0; CI, 2.1-12), whereas patients with baseline IVSd 20 to 24 mm had similar survival (HR, 1.4; CI, 0.7-2.8). Baseline IVSd was not correlated with New York Heart Association class, Canadian Cardiology Society class, or syncope. Clinical outcome was assessed 0.6±0.6 years after ASA. IVSd was not related to left ventricular outflow tract gradient reduction at rest (P=0.883) or during Valsalva maneuver (P=0.885). The proportion of patients in New York Heart Association class 3 to 4 was reduced from 86% to 10%; in Canadian Cardiology Society class 3 to 4 from 26% to 2%; and with syncope from 25% to 2%. There were no correlations between baseline IVSd and New York Heart Association class (P=0.067), Canadian Cardiology Society class (P=0.106), or syncope (P=0.426) after ASA. Conclusions - ASA had equal effects on left ventricular outflow tract gradients and symptoms throughout the spectrum of septal hypertrophy. Severe septal hypertrophy before ASA remained a marker of reduced survival after ASA with a 5-fold increased risk of all-cause mortality in patients with baseline IVSd >25 mm compared with patients with baseline IVSd <20 mm.

AB - Background - We assessed the influence of interventricular septal thickness (IVSd) on the clinical outcome and survival after alcohol septal ablation (ASA) in patient with hypertrophic cardiomyopathy. Methods and Results - We analyzed 531 patients with hypertrophic cardiomyopathy (age: 56±14 years, men 55%) treated with ASA. Survival status was obtained 7.9±4.0 years after ASA. Baseline IVSd was inversely associated with survival (hazard ratio [HR] for 1 mm increment, 1.13; confidence interval, 1.05-1.21; P<0.001) after adjustment for age, sex, body mass index, and ASA-performing center. Compared with patients with baseline IVSd <20 mm, patients with baseline IVSd ≥25 mm had reduced survival (HR, 5.0; CI, 2.1-12), whereas patients with baseline IVSd 20 to 24 mm had similar survival (HR, 1.4; CI, 0.7-2.8). Baseline IVSd was not correlated with New York Heart Association class, Canadian Cardiology Society class, or syncope. Clinical outcome was assessed 0.6±0.6 years after ASA. IVSd was not related to left ventricular outflow tract gradient reduction at rest (P=0.883) or during Valsalva maneuver (P=0.885). The proportion of patients in New York Heart Association class 3 to 4 was reduced from 86% to 10%; in Canadian Cardiology Society class 3 to 4 from 26% to 2%; and with syncope from 25% to 2%. There were no correlations between baseline IVSd and New York Heart Association class (P=0.067), Canadian Cardiology Society class (P=0.106), or syncope (P=0.426) after ASA. Conclusions - ASA had equal effects on left ventricular outflow tract gradients and symptoms throughout the spectrum of septal hypertrophy. Severe septal hypertrophy before ASA remained a marker of reduced survival after ASA with a 5-fold increased risk of all-cause mortality in patients with baseline IVSd >25 mm compared with patients with baseline IVSd <20 mm.

U2 - 10.1161/circinterventions.115.003214

DO - 10.1161/circinterventions.115.003214

M3 - Journal article

C2 - 27217377

SN - 1941-7640

VL - 9

JO - Circulation: Cardiovascular Interventions

JF - Circulation: Cardiovascular Interventions

IS - 6

M1 - e003214

ER -

Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy

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