Alcohol septal ablation markedly reduces energy loss in hypertrophic cardiomyopathy with left ventricular outflow tract obstruction: A four-dimensional flow cardiac magnetic resonance study.
4D flow MRI
4D, four-dimensional
ASA, alcohol septal ablation
Alcohol septal ablation
Energy loss
HCM, hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
LV, left ventricle/left ventricular
LVOT, left ventricular outflow tract
LVOTO, left ventricular outflow tract obstruction
Left ventricular outflow tract obstruction
MRI, magnetic resonance imaging
NYHA, New York Heart Association
ROI, region of interest
TTE, transthoracic echocardiography
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
09
06
2021
revised:
23
09
2021
accepted:
26
09
2021
entrez:
25
10
2021
pubmed:
26
10
2021
medline:
26
10
2021
Statut:
epublish
Résumé
Functional follow-up modalities of hypertrophic cardiomyopathy (HCM) with left ventricular (LV) outflow tract obstruction (LVOTO) subjected to alcohol septal ablation (ASA) are limited. This retrospective cohort study included patients of HCM with LVOTO who underwent ASA and four-dimensional (4D) flow cardiac magnetic resonance imaging (MRI) both before and after ASA. We analyzed energy loss in one cardiac cycle within the three-chamber plane of the LV and aortic root, and compared between pre- and post-ASA measurements. Of the 26 included patients, 10 (39%) were male, and median age was 71 (interquartile range 58-78) years. ASA significantly reduced not only LVOT pressure gradient (70 [19-50] to 9 [3-16], P < 0.001), but also energy loss during one cardiac cycle within the three-chamber plane of the LV and aortic root (80 [65-99] to 56 [45-70], P < 0.001). A linear association was observed between the reductions of energy loss and pressure gradient ( ASA significantly reduced energy loss within the LV and aortic root as quantified by 4D flow MRI, reflecting the decreased cardiac workload. This approach is a promising candidate for serial functional follow-up in patients undergoing ASA.
Sections du résumé
BACKGROUND
BACKGROUND
Functional follow-up modalities of hypertrophic cardiomyopathy (HCM) with left ventricular (LV) outflow tract obstruction (LVOTO) subjected to alcohol septal ablation (ASA) are limited.
METHODS
METHODS
This retrospective cohort study included patients of HCM with LVOTO who underwent ASA and four-dimensional (4D) flow cardiac magnetic resonance imaging (MRI) both before and after ASA. We analyzed energy loss in one cardiac cycle within the three-chamber plane of the LV and aortic root, and compared between pre- and post-ASA measurements.
RESULTS
RESULTS
Of the 26 included patients, 10 (39%) were male, and median age was 71 (interquartile range 58-78) years. ASA significantly reduced not only LVOT pressure gradient (70 [19-50] to 9 [3-16], P < 0.001), but also energy loss during one cardiac cycle within the three-chamber plane of the LV and aortic root (80 [65-99] to 56 [45-70], P < 0.001). A linear association was observed between the reductions of energy loss and pressure gradient (
CONCLUSIONS
CONCLUSIONS
ASA significantly reduced energy loss within the LV and aortic root as quantified by 4D flow MRI, reflecting the decreased cardiac workload. This approach is a promising candidate for serial functional follow-up in patients undergoing ASA.
Identifiants
pubmed: 34692989
doi: 10.1016/j.ijcha.2021.100886
pii: S2352-9067(21)00174-3
pmc: PMC8515238
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100886Informations de copyright
© 2021 The Author(s).
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SM is an employee of Cardio Flow Design Inc., Tokyo, Japan, the producer of iTFlow, a 4D flow MRI processing software. Other authors report no relationships that could be construed as a conflict of interest.
Références
Eur Heart J. 2015 Jul 1;36(25):1630
pubmed: 25736251
JACC Cardiovasc Imaging. 2019 Feb;12(2):252-266
pubmed: 30732721
Proc Natl Acad Sci U S A. 2018 Aug 28;115(35):E8143-E8152
pubmed: 30104387
J Cardiovasc Magn Reson. 2020 Feb 24;22(1):17
pubmed: 32089132
Curr Opin Neurol. 2016 Aug;29(4):419-28
pubmed: 27262148
Eur Heart J. 2014 Oct 14;35(39):2733-79
pubmed: 25173338
Int J Cardiol. 2017 Dec 15;249:486-493
pubmed: 28964555
Lancet. 2020 Sep 12;396(10253):759-769
pubmed: 32871100
Heart Vessels. 2020 May;35(5):647-654
pubmed: 31641886
Magn Reson Med. 2014 Sep;72(3):620-8
pubmed: 24122967
Circulation. 2011 Dec 13;124(24):e783-831
pubmed: 22068434
Circulation. 2012 Nov 13;126(20):2374-80
pubmed: 23076968
Eur Heart J. 2015 Mar 14;36(11):637
pubmed: 25265972
Eur Heart J Cardiovasc Imaging. 2019 Mar 1;20(3):323-333
pubmed: 30060051
Heart Vessels. 2017 Aug;32(8):1032-1044
pubmed: 28444501
Eur Heart J. 2020 Apr 7;41(14):1454
pubmed: 31504420