Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry

Josef Veselka; Lothar Faber; Max Liebregts; Robert Cooper; Jaroslav Januska; Jan Krejci; Thomas Bartel; Maciej Dabrowski; Peter Riis Hansen; Vibeke Marie Almaas; Hubert Seggewiss; Dieter Horstkotte; Radka Adlova; Henning Bundgaard; Jurriën ten Berg; Rodney Hilton Stables; Morten Kvistholm Jensen

doi:10.1161/JAHA.117.005735

Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry

Josef Veselka^*, Lothar Faber, Max Liebregts, Robert Cooper, Jaroslav Januska, Jan Krejci, Thomas Bartel, Maciej Dabrowski, Peter Riis Hansen, Vibeke Marie Almaas, Hubert Seggewiss, Dieter Horstkotte, Radka Adlova, Henning Bundgaard, Jurriën ten Berg, Rodney Hilton Stables, Morten Kvistholm Jensen

^*Corresponding author af dette arbejde

16 Citationer (Scopus)

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Abstract

Background- The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA. Methods and Results- We retrospectively evaluated consecutive patients enrolled in the Euro-ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre-ASA. The median (interquartile range) follow-up was 4.8 (1.7-8.5) years. The clinical outcome was assessed and compared with the age- and sex-matched general population. The 30-day mortality after ASA was 0.6% and the annual all-cause mortality rate was 1.7%, which was similar to the age- and sex-matched general population (P=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (P < 0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (P < 0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively. Conclusions- Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population.

Originalsprog	Engelsk
Artikelnummer	e005735
Tidsskrift	Journal of the American Heart Association
Vol/bind	6
Udgave nummer	5
ISSN	2047-9980
DOI	https://doi.org/10.1161/JAHA.117.005735
Status	Udgivet - maj 2017

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10.1161/JAHA.117.005735Licens: CC BY-NC

Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy: A Long‐Term Follow‐Up Study Based on the Euro‐Alcohol Septal Ablation RegistryForlagets udgivne version, 806 KBLicens: CC BY-NC

Citationsformater

Veselka, J., Faber, L., Liebregts, M., Cooper, R., Januska, J., Krejci, J., Bartel, T., Dabrowski, M., Hansen, P. R., Almaas, V. M., Seggewiss, H., Horstkotte, D., Adlova, R., Bundgaard, H., Berg, J. T., Stables, R. H., & Jensen, M. K. (2017). Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry. Journal of the American Heart Association, 6(5), Artikel e005735. https://doi.org/10.1161/JAHA.117.005735

Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry. / Veselka, Josef; Faber, Lothar; Liebregts, Max et al.
I: Journal of the American Heart Association, Bind 6, Nr. 5, e005735, 05.2017.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Veselka, J, Faber, L, Liebregts, M, Cooper, R, Januska, J, Krejci, J, Bartel, T, Dabrowski, M, Hansen, PR, Almaas, VM, Seggewiss, H, Horstkotte, D, Adlova, R, Bundgaard, H, Berg, JT, Stables, RH & Jensen, MK 2017, 'Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry', Journal of the American Heart Association, bind 6, nr. 5, e005735. https://doi.org/10.1161/JAHA.117.005735

@article{631de3967c61400fa88e098d76f8ba9b,

title = "Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry",

abstract = "Background- The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA. Methods and Results- We retrospectively evaluated consecutive patients enrolled in the Euro-ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre-ASA. The median (interquartile range) follow-up was 4.8 (1.7-8.5) years. The clinical outcome was assessed and compared with the age- and sex-matched general population. The 30-day mortality after ASA was 0.6% and the annual all-cause mortality rate was 1.7%, which was similar to the age- and sex-matched general population (P=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (P < 0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (P < 0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively. Conclusions- Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population.",

keywords = "Ablation, Hypertrophic cardiomyopathy, Outcome",

author = "Josef Veselka and Lothar Faber and Max Liebregts and Robert Cooper and Jaroslav Januska and Jan Krejci and Thomas Bartel and Maciej Dabrowski and Hansen, {Peter Riis} and Almaas, {Vibeke Marie} and Hubert Seggewiss and Dieter Horstkotte and Radka Adlova and Henning Bundgaard and Berg, {Jurri{\"e}n ten} and Stables, {Rodney Hilton} and Jensen, {Morten Kvistholm}",

year = "2017",

month = may,

doi = "10.1161/JAHA.117.005735",

language = "English",

volume = "6",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "Wiley-Blackwell",

number = "5",

}

TY - JOUR

T1 - Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy

T2 - A long-term follow-up study based on the Euro-alcohol septal ablation registry

AU - Veselka, Josef

AU - Faber, Lothar

AU - Liebregts, Max

AU - Cooper, Robert

AU - Januska, Jaroslav

AU - Krejci, Jan

AU - Bartel, Thomas

AU - Dabrowski, Maciej

AU - Hansen, Peter Riis

AU - Almaas, Vibeke Marie

AU - Seggewiss, Hubert

AU - Horstkotte, Dieter

AU - Adlova, Radka

AU - Bundgaard, Henning

AU - Berg, Jurriën ten

AU - Stables, Rodney Hilton

AU - Jensen, Morten Kvistholm

PY - 2017/5

Y1 - 2017/5

N2 - Background- The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA. Methods and Results- We retrospectively evaluated consecutive patients enrolled in the Euro-ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre-ASA. The median (interquartile range) follow-up was 4.8 (1.7-8.5) years. The clinical outcome was assessed and compared with the age- and sex-matched general population. The 30-day mortality after ASA was 0.6% and the annual all-cause mortality rate was 1.7%, which was similar to the age- and sex-matched general population (P=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (P < 0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (P < 0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively. Conclusions- Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population.

AB - Background- The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with ASA. Methods and Results- We retrospectively evaluated consecutive patients enrolled in the Euro-ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre-ASA. The median (interquartile range) follow-up was 4.8 (1.7-8.5) years. The clinical outcome was assessed and compared with the age- and sex-matched general population. The 30-day mortality after ASA was 0.6% and the annual all-cause mortality rate was 1.7%, which was similar to the age- and sex-matched general population (P=0.62). A total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm Hg. Obstruction was reduced from 63±32 to 15±19 mm Hg (P < 0.01), and the mean NYHA class decreased from 2.0±0 to 1.3±0.1 (P < 0.01); 69%, 29%, and 2% of patients were in NYHA class I, II, and III at the last clinical checkup, respectively. Conclusions- Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population.

KW - Ablation

KW - Hypertrophic cardiomyopathy

KW - Outcome

U2 - 10.1161/JAHA.117.005735

DO - 10.1161/JAHA.117.005735

M3 - Journal article

C2 - 28512112

AN - SCOPUS:85019345602

SN - 2047-9980

VL - 6

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 5

M1 - e005735

ER -

Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry

Abstract

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