Skip to main content
Erschienen in: Heart and Vessels 5/2016

05.03.2015 | Original Article

Effects of alcohol septal ablation on left ventricular diastolic filling patterns in obstructive hypertrophic cardiomyopathy

verfasst von: You-Zhou Chen, Fu-Jian Duan, Jian-Song Yuan, Feng-Huan Hu, Jin-Gang Cui, Wei-Xian Yang, Yan Zhang, Hao Wang, Shu-Bin Qiao

Erschienen in: Heart and Vessels | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Alcohol septal ablation (ASA) has been shown to improve left ventricular (LV) diastolic function in patients with obstructive hypertrophic cardiomyopathy (HCM). However, its beneficial effect on diastolic function assessed by cardiac magnetic resonance (CMR) has not been reported. We investigated the mid-term changes of diastolic function by CMR combined with echocardiography in HCM patients after ASA at a median of 14-month follow-up. CMR parameters of diastolic function including peak filling rate (PFR), and time to peak filling rate (TPFR) were evaluated in 43 patients (aged 48 ± 9 years). LV diastolic function improved significantly measured by echocardiography with the decrease in ratio of transmitral early LV filling velocity (E) to early diastolic mitral lateral annular velocity (E′) (14.20 ± 1.17 to 11.58 ± 1.16, p < 0.001) and E-wave deceleration time (194.04 ± 19.30 to 168.45 ± 12.58 ms, p < 0.001). PFR increased significantly with associated decrease in TPFR after ASA (both p < 0.001) at follow-up. Furthermore, patients with larger decrease in LVOT gradients had a greater improvement of LV diastolic function, as measured by the reduction of E/E′ (p < 0.001) and increase of PFR (p < 0.001). In conclusion, this study demonstrated that successful ASA results in both echocardiographic and CMR indices of diastolic function improvement after ASA at 14-month follow-up. ASA therapy can significantly reduce LVOT gradient and mitral regurgitation, both of which may contribute to the improvement of diastolic function.
Literatur
1.
Zurück zum Zitat Fujita E, Nakanishi T, Nishizawa T, Hagiwara N, Matsuoka R (2013) Mutations in the cardiac troponin T gene show various prognoses in Japanese patients with hypertrophic cardiomyopathy. Heart Vessel 28:785–794CrossRef Fujita E, Nakanishi T, Nishizawa T, Hagiwara N, Matsuoka R (2013) Mutations in the cardiac troponin T gene show various prognoses in Japanese patients with hypertrophic cardiomyopathy. Heart Vessel 28:785–794CrossRef
3.
Zurück zum Zitat Ho CY, Sweitzer NK, McDonough B, Maron BJ, Casey SA, Seidman JG, Seidman CE, Solomon SD (2002) Assessment of diastolic function with Doppler tissue imaging to predict genotype in preclinical hypertrophic cardiomyopathy. Circulation 105:2992–2997CrossRefPubMed Ho CY, Sweitzer NK, McDonough B, Maron BJ, Casey SA, Seidman JG, Seidman CE, Solomon SD (2002) Assessment of diastolic function with Doppler tissue imaging to predict genotype in preclinical hypertrophic cardiomyopathy. Circulation 105:2992–2997CrossRefPubMed
4.
Zurück zum Zitat Meliga E, Steendijk P, Valgimigli M, Ten CF, Serruys PW (2008) Effects of percutaneous transluminal septal myocardial ablation for obstructive hypertrophic cardiomyopathy on systolic and diastolic left ventricular function assessed by pressure-volume loops. Am J Cardiol 101:1179–1184CrossRefPubMed Meliga E, Steendijk P, Valgimigli M, Ten CF, Serruys PW (2008) Effects of percutaneous transluminal septal myocardial ablation for obstructive hypertrophic cardiomyopathy on systolic and diastolic left ventricular function assessed by pressure-volume loops. Am J Cardiol 101:1179–1184CrossRefPubMed
5.
Zurück zum Zitat Steendijk P, Meliga E, Valgimigli M, Ten CF, Serruys PW (2008) Acute effects of alcohol septal ablation on systolic and diastolic left ventricular function in patients with hypertrophic obstructive cardiomyopathy. Heart 94:1318–1322CrossRefPubMed Steendijk P, Meliga E, Valgimigli M, Ten CF, Serruys PW (2008) Acute effects of alcohol septal ablation on systolic and diastolic left ventricular function in patients with hypertrophic obstructive cardiomyopathy. Heart 94:1318–1322CrossRefPubMed
6.
Zurück zum Zitat Jassal DS, Neilan TG, Fifer MA, Palacios IF, Lowry PA, Vlahakes GJ, Picard MH, Yoerger DM (2006) Sustained improvement in left ventricular diastolic function after alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Eur Heart J 27:1805–1810CrossRefPubMed Jassal DS, Neilan TG, Fifer MA, Palacios IF, Lowry PA, Vlahakes GJ, Picard MH, Yoerger DM (2006) Sustained improvement in left ventricular diastolic function after alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Eur Heart J 27:1805–1810CrossRefPubMed
7.
Zurück zum Zitat Veselka J, Zemanek D, Tomasov P, Duchonova R, Linhartova K (2009) Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: ultra-low dose of alcohol (1 ml) is still effective. Heart Vessel 24:27–31CrossRef Veselka J, Zemanek D, Tomasov P, Duchonova R, Linhartova K (2009) Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: ultra-low dose of alcohol (1 ml) is still effective. Heart Vessel 24:27–31CrossRef
8.
Zurück zum Zitat Geske JB, Sorajja P, Nishimura RA, Ommen SR (2007) Evaluation of left ventricular filling pressures by Doppler echocardiography in patients with hypertrophic cardiomyopathy: correlation with direct left atrial pressure measurement at cardiac catheterization. Circulation 116:2702–2708CrossRefPubMed Geske JB, Sorajja P, Nishimura RA, Ommen SR (2007) Evaluation of left ventricular filling pressures by Doppler echocardiography in patients with hypertrophic cardiomyopathy: correlation with direct left atrial pressure measurement at cardiac catheterization. Circulation 116:2702–2708CrossRefPubMed
9.
Zurück zum Zitat Sato T, Yamanari H, Ohe T, Yoshinouchi T (1996) Regional left ventricular contractile dynamics in hypertrophic cardiomyopathy evaluated by magnetic resonance imaging. Heart Vessel 11:248–254CrossRef Sato T, Yamanari H, Ohe T, Yoshinouchi T (1996) Regional left ventricular contractile dynamics in hypertrophic cardiomyopathy evaluated by magnetic resonance imaging. Heart Vessel 11:248–254CrossRef
10.
Zurück zum Zitat Daneshvar D, Wei J, Tolstrup K, Thomson LE, Shufelt C, Merz CN (2010) Diastolic dysfunction: improved understanding using emerging imaging techniques. Am Heart J 160:394–404CrossRefPubMed Daneshvar D, Wei J, Tolstrup K, Thomson LE, Shufelt C, Merz CN (2010) Diastolic dysfunction: improved understanding using emerging imaging techniques. Am Heart J 160:394–404CrossRefPubMed
11.
Zurück zum Zitat Zeidan Z, Erbel R, Barkhausen J, Hunold P, Bartel T, Buck T (2003) Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography. J Am Soc Echocardiogr 16:29–37CrossRefPubMed Zeidan Z, Erbel R, Barkhausen J, Hunold P, Bartel T, Buck T (2003) Analysis of global systolic and diastolic left ventricular performance using volume-time curves by real-time three-dimensional echocardiography. J Am Soc Echocardiogr 16:29–37CrossRefPubMed
12.
Zurück zum Zitat Mendoza DD, Codella NC, Wang Y, Prince MR, Sethi S, Manoushagian SJ, Kawaji K, Min JK, LaBounty TM, Devereux RB, Weinsaft JW (2010) Impact of diastolic dysfunction severity on global left ventricular volumetric filling—assessment by automated segmentation of routine cine cardiovascular magnetic resonance. J Cardiovasc Magn Reson 12:46CrossRefPubMedPubMedCentral Mendoza DD, Codella NC, Wang Y, Prince MR, Sethi S, Manoushagian SJ, Kawaji K, Min JK, LaBounty TM, Devereux RB, Weinsaft JW (2010) Impact of diastolic dysfunction severity on global left ventricular volumetric filling—assessment by automated segmentation of routine cine cardiovascular magnetic resonance. J Cardiovasc Magn Reson 12:46CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Sorajja P, Ommen SR, Holmes DJ, Dearani JA, Rihal CS, Gersh BJ, Lennon RJ, Nishimura RA (2012) Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation 126:2374–2380CrossRefPubMed Sorajja P, Ommen SR, Holmes DJ, Dearani JA, Rihal CS, Gersh BJ, Lennon RJ, Nishimura RA (2012) Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation 126:2374–2380CrossRefPubMed
14.
Zurück zum Zitat Sorajja P, Valeti U, Nishimura RA, Ommen SR, Rihal CS, Gersh BJ, Hodge DO, Schaff HV, Holmes DJ (2008) Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation 118:131–139CrossRefPubMed Sorajja P, Valeti U, Nishimura RA, Ommen SR, Rihal CS, Gersh BJ, Hodge DO, Schaff HV, Holmes DJ (2008) Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation 118:131–139CrossRefPubMed
15.
Zurück zum Zitat Saji M, Takamisawa I, Iguchi N, Takayama M (2013) Cardiac MRI detected septal and lateral myocardial infarction by alcohol septal ablation through the intermediate artery. Heart Vessel 28:672–676CrossRef Saji M, Takamisawa I, Iguchi N, Takayama M (2013) Cardiac MRI detected septal and lateral myocardial infarction by alcohol septal ablation through the intermediate artery. Heart Vessel 28:672–676CrossRef
16.
Zurück zum Zitat Machida H, Nunoda S, Okajima K, Shitakura K, Sekikawa A, Kubo Y, Otsuka K, Hirata M, Kojima S, Ueno E (2012) Magnetic resonance assessment of left ventricular diastolic dysfunction for detecting cardiac allograft vasculopathy in recipients of heart transplants. Int J Cardiovasc Imaging 28:555–562CrossRefPubMed Machida H, Nunoda S, Okajima K, Shitakura K, Sekikawa A, Kubo Y, Otsuka K, Hirata M, Kojima S, Ueno E (2012) Magnetic resonance assessment of left ventricular diastolic dysfunction for detecting cardiac allograft vasculopathy in recipients of heart transplants. Int J Cardiovasc Imaging 28:555–562CrossRefPubMed
17.
Zurück zum Zitat Rodriguez-Granillo GA, Mejia-Campillo M, Rosales MA, Bolzan G, Ingino C, Lopez F, Degrossi E, Lylyk P (2012) Left ventricular filling patterns in patients with previous myocardial infarction measured by conventional cine cardiac magnetic resonance. Int J Cardiovasc Imaging 28:795–801CrossRefPubMed Rodriguez-Granillo GA, Mejia-Campillo M, Rosales MA, Bolzan G, Ingino C, Lopez F, Degrossi E, Lylyk P (2012) Left ventricular filling patterns in patients with previous myocardial infarction measured by conventional cine cardiac magnetic resonance. Int J Cardiovasc Imaging 28:795–801CrossRefPubMed
18.
Zurück zum Zitat Nagueh SF, Lakkis NM, Middleton KJ, Killip D, Zoghbi WA, Quinones MA, Spencer WR (1999) Changes in left ventricular filling and left atrial function six months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol 34:1123–1128CrossRefPubMed Nagueh SF, Lakkis NM, Middleton KJ, Killip D, Zoghbi WA, Quinones MA, Spencer WR (1999) Changes in left ventricular filling and left atrial function six months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol 34:1123–1128CrossRefPubMed
19.
Zurück zum Zitat Nishimura RA, Appleton CP, Redfield MM, Ilstrup DM, Holmes DJ, Tajik AJ (1996) Noninvasive doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: a simultaneous Doppler echocardiographic and cardiac catheterization study. J Am Coll Cardiol 28:1226–1233CrossRefPubMed Nishimura RA, Appleton CP, Redfield MM, Ilstrup DM, Holmes DJ, Tajik AJ (1996) Noninvasive doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: a simultaneous Doppler echocardiographic and cardiac catheterization study. J Am Coll Cardiol 28:1226–1233CrossRefPubMed
20.
Zurück zum Zitat Rakowski H, Carasso S (2007) Quantifying diastolic function in hypertrophic cardiomyopathy: the ongoing search for the holy grail. Circulation 116:2662–2665CrossRefPubMed Rakowski H, Carasso S (2007) Quantifying diastolic function in hypertrophic cardiomyopathy: the ongoing search for the holy grail. Circulation 116:2662–2665CrossRefPubMed
21.
Zurück zum Zitat Newman H, Sugrue D, Oakley CM, Goodwin JF, McKenna WJ (1985) Relation of left ventricular function and prognosis in hypertrophic cardiomyopathy: an angiographic study. J Am Coll Cardiol 5:1064–1074CrossRefPubMed Newman H, Sugrue D, Oakley CM, Goodwin JF, McKenna WJ (1985) Relation of left ventricular function and prognosis in hypertrophic cardiomyopathy: an angiographic study. J Am Coll Cardiol 5:1064–1074CrossRefPubMed
22.
Zurück zum Zitat Betocchi S, Losi MA, Piscione F, Boccalatte M, Pace L, Golino P, Perrone-Filardi P, Briguori C, Franculli F, Pappone C, Salvatore M, Chiariello M (1996) Effects of dual-chamber pacing in hypertrophic cardiomyopathy on left ventricular outflow tract obstruction and on diastolic function. Am J Cardiol 77:498–502CrossRefPubMed Betocchi S, Losi MA, Piscione F, Boccalatte M, Pace L, Golino P, Perrone-Filardi P, Briguori C, Franculli F, Pappone C, Salvatore M, Chiariello M (1996) Effects of dual-chamber pacing in hypertrophic cardiomyopathy on left ventricular outflow tract obstruction and on diastolic function. Am J Cardiol 77:498–502CrossRefPubMed
23.
Zurück zum Zitat Kudelka AM, Turner DA, Liebson PR, Macioch JE, Wang JZ, Barron JT (1997) Comparison of cine magnetic resonance imaging and Doppler echocardiography for evaluation of left ventricular diastolic function. Am J Cardiol 80:384–386CrossRefPubMed Kudelka AM, Turner DA, Liebson PR, Macioch JE, Wang JZ, Barron JT (1997) Comparison of cine magnetic resonance imaging and Doppler echocardiography for evaluation of left ventricular diastolic function. Am J Cardiol 80:384–386CrossRefPubMed
24.
Zurück zum Zitat Kawaji K, Codella NC, Prince MR, Chu CW, Shakoor A, LaBounty TM, Min JK, Swaminathan RV, Devereux RB, Wang Y, Weinsaft JW (2009) Automated segmentation of routine clinical cardiac magnetic resonance imaging for assessment of left ventricular diastolic dysfunction. Circ Cardiovasc Imaging 2:476–484CrossRefPubMed Kawaji K, Codella NC, Prince MR, Chu CW, Shakoor A, LaBounty TM, Min JK, Swaminathan RV, Devereux RB, Wang Y, Weinsaft JW (2009) Automated segmentation of routine clinical cardiac magnetic resonance imaging for assessment of left ventricular diastolic dysfunction. Circ Cardiovasc Imaging 2:476–484CrossRefPubMed
25.
Zurück zum Zitat Nagueh SF, Lakkis NM, Middleton KJ, Spencer WR, Zoghbi WA, Quinones MA (1999) Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation 99:254–261CrossRefPubMed Nagueh SF, Lakkis NM, Middleton KJ, Spencer WR, Zoghbi WA, Quinones MA (1999) Doppler estimation of left ventricular filling pressures in patients with hypertrophic cardiomyopathy. Circulation 99:254–261CrossRefPubMed
26.
Zurück zum Zitat Sorajja P, Nishimura RA, Ommen SR, Rihal CS, Gersh BJ, Holmes DJ (2008) Effect of septal ablation on myocardial relaxation and left atrial pressure in hypertrophic cardiomyopathy an invasive hemodynamic study. JACC Cardiovasc Interv 1:552–560CrossRefPubMed Sorajja P, Nishimura RA, Ommen SR, Rihal CS, Gersh BJ, Holmes DJ (2008) Effect of septal ablation on myocardial relaxation and left atrial pressure in hypertrophic cardiomyopathy an invasive hemodynamic study. JACC Cardiovasc Interv 1:552–560CrossRefPubMed
27.
Zurück zum Zitat Araujo AQ, Arteaga E, Ianni BM, Fernandes F, Ramires FJ, Buck PC, Salemi VM, Nastari L, Mady C (2006) Relationship between outflow obstruction and left ventricular functional impairment in hypertrophic cardiomyopathy: a Doppler echocardiographic study. Echocardiography 23:734–740CrossRefPubMed Araujo AQ, Arteaga E, Ianni BM, Fernandes F, Ramires FJ, Buck PC, Salemi VM, Nastari L, Mady C (2006) Relationship between outflow obstruction and left ventricular functional impairment in hypertrophic cardiomyopathy: a Doppler echocardiographic study. Echocardiography 23:734–740CrossRefPubMed
28.
Zurück zum Zitat Talreja DR, Nishimura RA, Edwards WD, Valeti US, Ommen SR, Tajik AJ, Dearani JA, Schaff HV, Holmes DJ (2004) Alcohol septal ablation versus surgical septal myectomy: comparison of effects on atrioventricular conduction tissue. J Am Coll Cardiol 44:2329–2332CrossRefPubMed Talreja DR, Nishimura RA, Edwards WD, Valeti US, Ommen SR, Tajik AJ, Dearani JA, Schaff HV, Holmes DJ (2004) Alcohol septal ablation versus surgical septal myectomy: comparison of effects on atrioventricular conduction tissue. J Am Coll Cardiol 44:2329–2332CrossRefPubMed
29.
Zurück zum Zitat Qin JX, Shiota T, Lever HM, Asher CR, Popovic ZB, Greenberg NL, Agler DA, Drinko JK, Smedira NG, Tuzcu EM, Lytle BW, Thomas JD (2004) Conduction system abnormalities in patients with obstructive hypertrophic cardiomyopathy following septal reduction interventions. Am J Cardiol 93:171–175CrossRefPubMed Qin JX, Shiota T, Lever HM, Asher CR, Popovic ZB, Greenberg NL, Agler DA, Drinko JK, Smedira NG, Tuzcu EM, Lytle BW, Thomas JD (2004) Conduction system abnormalities in patients with obstructive hypertrophic cardiomyopathy following septal reduction interventions. Am J Cardiol 93:171–175CrossRefPubMed
30.
Zurück zum Zitat Valeti US, Nishimura RA, Holmes DR, Araoz PA, Glockner JF, Breen JF, Ommen SR, Gersh BJ, Tajik AJ, Rihal CS, Schaff HV, Maron BJ (2007) Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic resonance imaging in patients with hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol 49:350–357CrossRefPubMed Valeti US, Nishimura RA, Holmes DR, Araoz PA, Glockner JF, Breen JF, Ommen SR, Gersh BJ, Tajik AJ, Rihal CS, Schaff HV, Maron BJ (2007) Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic resonance imaging in patients with hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol 49:350–357CrossRefPubMed
31.
Zurück zum Zitat Nagueh SF, Lakkis NM, Middleton KJ, Killip D, Zoghbi WA, Quinones MA, Spencer WR (1999) Changes in left ventricular diastolic function 6 months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy. Circulation 99:344–347CrossRefPubMed Nagueh SF, Lakkis NM, Middleton KJ, Killip D, Zoghbi WA, Quinones MA, Spencer WR (1999) Changes in left ventricular diastolic function 6 months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy. Circulation 99:344–347CrossRefPubMed
Metadaten
Titel
Effects of alcohol septal ablation on left ventricular diastolic filling patterns in obstructive hypertrophic cardiomyopathy
verfasst von
You-Zhou Chen
Fu-Jian Duan
Jian-Song Yuan
Feng-Huan Hu
Jin-Gang Cui
Wei-Xian Yang
Yan Zhang
Hao Wang
Shu-Bin Qiao
Publikationsdatum
05.03.2015
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 5/2016
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-015-0656-2

Weitere Artikel der Ausgabe 5/2016

Heart and Vessels 5/2016 Zur Ausgabe

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Komplette Revaskularisation bei Infarkt: Neue Studie setzt ein Fragezeichen

24.04.2024 ACC 2024 Nachrichten

Eine FFR-gesteuerte komplette Revaskularisation war in einer Studie bei Patienten mit akutem Myokardinfarkt und koronarer Mehrgefäßerkrankung klinisch nicht wirksamer als eine alleinige Revaskularisation der Infarktarterie.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.