Author + information
- Received March 27, 2018
- Revision received July 17, 2018
- Accepted July 23, 2018
- Published online October 8, 2018.
- Liwen Liu, MD, PhDa,∗∗ (, )
- Jing Li, MBBSa,∗,
- Lei Zuo, MBBSa,
- Jinzhou Zhang, MD, PhDb,
- Mengyao Zhou, MBBSa,
- Bo Xu, MBBSb,
- Rebeccca T. Hahn, MDc,
- Martin B. Leon, MDc,
- David H. Hsi, MDd,
- Junbo Ge, MD, PhDe,
- Xiaodong Zhou, MD, PhDa,
- Jun Zhang, MD, PhDa,
- Shuping Ge, MD, PhDf and
- Lize Xiong, MD, PhDg,∗∗ (, )@CRFHeart
- aXijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- bXijing Hypertrophic Cardiomyopathy Center, Department of Cardiac Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- cColumbia University Medical Center/New York Presbyterian Hospital, New York, New York
- dHeart & Vascular Institute, Stamford Hospital, Stamford, Connecticut
- eShanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China
- fDepartment of Cardiology, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania
- gXijing Hypertrophic Cardiomyopathy Center, Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- ↵∗Address for correspondence:
Dr. Liwen Liu, Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, 127 Changle West Road, Xi’an, 710032 Shaanxi, China.
- ↵∗∗Dr. Lize Xiong, Xijing Hypertrophic Cardiomyopathy Center, Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, 127 Changle West Road, Xi’an 710032, Shaanxi, China.
Background In patients with disabling symptoms caused by hypertrophic obstructive cardiomyopathy (HOCM), echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) could be a less invasive treatment option.
Objectives This study aimed to investigate the safety and efficacy of the PIMSRA for left ventricular outflow tract (LVOT) gradient reduction in HOCM.
Methods The study enrolled 15 patients with HOCM. These patients underwent electrocardiography, imaging, and blood biochemistry examination over 6 months of follow-up.
Results At 6 months of follow-up, patients showed significant reductions in peak LVOT gradients (resting gradient: from 88.00 [66.00] mm Hg to 11.00 [6.00] mm Hg; p = 0.001; stress-induced gradient: from 117.00 [81.00] mm Hg to 25.00 [20.00] mm Hg; p = 0.005) and interventricular septum (IVS) thickness (anterior IVS: from 25.00 [21.00] mm to 14.00 [12.00] mm; p = 0.001; posterior IVS: from 24.00 [21.00] mm to 14.00 [11.50] mm; p = 0.001). The reductions in IVS thickness and LVOT gradients were associated with improvement in New York Heart Association functional classification (from 3.00 [2.00] to 1.00 [1.00]; p < 0.001), total exercise time (from 6.00 [5.50] min to 9.00 [8.00] min; p = 0.007), and pro B-type natriuretic peptide levels (from 924.00 [370.45] pg/ml to 137.45 [75.73] pg/ml; p = 0.028). No patient had bundle branch block or complete heart block.
Conclusions PIMSRA is a safe and effective treatment approach for severe, symptomatic HOCM and results in sustained improvement in exercise capacity, persistent reduction in LVOT gradient, and sustained improvement in cardiac function.
- echocardiography-guided septal ablation
- hypertrophic obstructive cardiomyopathy
- percutaneous intramyocardial
- radiofrequency septal ablation
↵∗ Drs. Liu and Li contributed equally to this work.
This study was supported by International Cooperation Funding of the China Science and Technology Ministry (grant No. 2014DFA31980); National Natural Science Foundation of China (grant No. 81671693); Shaanxi Provincial Key Project (grant No. 2017ZDXM-SF-058); and a Xijing Funded Project for New Technologies and Services (grant No. 417432A). Dr. Leon is a nonpaid member of the Scientific Advisory Board of Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 27, 2018.
- Revision received July 17, 2018.
- Accepted July 23, 2018.
- 2018 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.