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Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy: Outcomes in Young, Middle-Aged, and Elderly Patients
被引:14
作者:

Leonardi, Robert A.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Townsend, Jacob C.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Patel, Chetan A.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Wolf, Bethany J.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Todoran, Thomas M.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Powers, Eric R.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Steinberg, Daniel H.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Fernandes, Valerian L.
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Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA

Nielsen, Christopher D.
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h-index: 0
机构:
Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA
机构:
[1] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA
关键词:
hypertrophic cardiomyopathy;
alcohol septal ablation;
age;
PERCUTANEOUS CORONARY INTERVENTION;
SUDDEN CARDIAC DEATH;
COMPLETE HEART-BLOCK;
TRANSCORONARY ABLATION;
RISK STRATIFICATION;
PREVENTION;
DEFIBRILLATORS;
METAANALYSIS;
PREDICTORS;
MYECTOMY;
D O I:
10.1002/ccd.24643
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
ObjectivesWe compared the efficacy and safety of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) in young, middle-aged, and elderly patients. BackgroundIntersociety guidelines suggest based on limited evidence that young patients with medically refractory symptoms of obstructive HCM should undergo surgical myectomy while elderly patients may be more appropriate for ASA. MethodsData for 360 patients undergoing 389 ASAs were prospectively collected and retrospectively analyzed according to age. ResultsYoung (<45 years), middle-aged (45-64 years), and elderly (65 years) patients comprised 28, 40, and 32% of the study population, respectively. Young patients had thicker left ventricular septal walls at baseline, and elderly patients had more comorbidity and dyspnea. Resting, mean left ventricular outflow tract gradients (LVOTGs) were similar across the age groups at baseline (62, 66, and 68 mm Hg, respectively; P = NS for all comparisons). LVOTGs and dyspnea were significantly and similarly improved in all age groups immediately after ASA and through 12 months of follow-up (P < 0.001 for before and after comparisons; P = NS for intergroup comparisons). Complication rates were similar for young and middle-aged patients but higher for elderly patients (9.1 and 6.3% vs. 20.8%, respectively; P 0.016 for elderly vs. others). Mortality rates for young and middle-aged patients were lower than for elderly patients, but the differences were not statistically significant. ConclusionsPatients undergoing ASA had significant and similar improvements in LVOTGs and symptoms regardless of age. Procedural complications were increased in elderly patients, who had numerically but not statistically significantly higher mortality rates. (c) 2012 Wiley Periodicals, Inc.
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页码:838 / 845
页数:8
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