Alcohol dose in septal ablation for hypertrophic obstructive cardiomyopathy

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:333

Article

Veselka, Josef¹  Faber, Lothar²  Liebregts, Max³  Cooper, Robert⁴  Januska, Jaroslav⁵  Kashtanov, Maksim^6,7  Dabrowski, Maciej⁸  Hansen, Peter Riis⁹  Seggewiss, Hubert¹⁰  Bonaventura, Jiri¹  Polakova, Eva¹  Hansvenclova, Eva¹  Bundgaard, Henning¹¹  ten Berg, Jurrien³  Stables, Rodney Hilton⁴  Jarkovsky, Jiri^12,13  Jensen, Morten Kvistholm¹¹ 

[1] Charles Univ Prague, Univ Hosp Motol, Med Sch 2, Dept Cardiol, Prague, Czech Republic

[2] Ruhr Univ Bochum, Bochum, Germany

[3] St Antonius Hosp Nieuwegein, Dept Cardiol, Nieuwegein, Netherlands

[4] Liverpool Heart & Chest Hosp, Inst Cardiovasc Med & Sci, Liverpool, Merseyside, England

[5] Cardioctr Podlesi, Trinec, Czech Republic

[6] Sverdlovsk Reg Hosp N1, Dept Endovasc Therapy, Ekaterinburg, Russia

[7] Ural Fed Univ, Ekaterinburg, Russia

[8] Inst Cardiol, Dept Intervent Cardiol & Angiol, Warsaw, Poland

[9] Herlev & Gentofte Hosp, Dept Cardiol, Hellerup, Denmark

[10] Univ Klinikum Wurzburg, Deutsch Zentrum Herzinsuffizienz, Wurzburg, Germany

[11] Copenhagen Univ Hosp, Rigshosp, Dept Cardiol, Unit Inherited Cardiac Dis, Copenhagen, Denmark

[12] Masaryk Univ, Fac Med, Inst Biostat & Anal, Brno, Czech Republic

[13] Masaryk Univ, Fac Sci, Brno, Czech Republic

关键词: Alcohol septal ablation;    Hypertrophic cardiomyopathy;    Alcohol dose;   

DOI  :  10.1016/j.ijcard.2021.02.056

来源: Elsevier

【 摘 要 】

Background: The aim of this study was to evaluate short-and long-term outcomes related to dose of alcohol administered during alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Current guidelines recommend using 1-3 mL of alcohol administered in the target septal perforator artery, but this recommendation is based more on practical experience of interventionalists rather than on systematic evidence. Methods: We included 1448 patients and used propensity score to match patients who received a low-dose (1.0-1.9 mL) versus a high-dose (2.0-3.8 mL) of alcohol during ASA. Results: The matched cohort analysis comprised 770 patients (n = 385 in both groups). There was a similar occurrence of 30-day post-procedural adverse events (13% vs. 12%; p = 0.59), and similar all-cause mortality rates (0.8% vs. 0.5%; p = 1) in the low-dose group and the high-dose group, respectively. In the long-term follow-up (5.4 +/- 4.5 years), a total of 110 (14%) patients died representing 2.58 deaths and 2.64 deaths per 100 patient years in the low dose and the high dose group (logrank, p = 0.92), respectively. There were no significant differences in the long-term dyspnea and left ventricular outflow gradient between the two groups. Patients treated with a low-dose of alcohol underwent more subsequent septal reduction procedures (logrank, p = 0.04). Conclusions: Matched HOCM patients undergoing ASA with a low-dose (1.0-1.9 mL) or a high-dose (2.0-3.8 mL) of alcohol had similar short-and long-term outcomes. A higher rate of repeated septal reduction procedures was observed in the group treated with a low-dose of alcohol. (c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

【 授权许可】

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