Key result
Percutaneous intramyocardial septal radiofrequency ablation linked to ~72% lower resting LVOT gradients and improved symptoms.
Why the study?
The study aimed to evaluate changes in left ventricular diastolic function and clinical symptom improvement after percutaneous intramyocardial septal radiofrequency ablation in hypertrophic cardiomyopathy patients with HFpEF.
Does percutaneous intramyocardial septal radiofrequency ablation improve left ventricular diastolic function and clinical symptoms in adult hypertrophic cardiomyopathy patients with HFpEF?
Observational (n=31)
Does percutaneous intramyocardial septal radiofrequency ablation improve left ventricular diastolic function and clinical symptoms in adult hypertrophic cardiomyopathy patients with HFpEF?
Absolute Event Rate: 23.4% vs 83.24%
p-value: p=<0.001
Percutaneous intramyocardial septal radiofrequency ablation significantly reduces left ventricular outflow tract gradients and improves diastolic function and quality of life in HCM patients with HFpEF at 6 months.
May improve symptoms in HCM-HFpEF; hypothesis-generating, requires RCTs before practice change.
BACKGROUND: The study aimed to evaluate the changes of left ventricular diastolic function and the improvement of clinical symptoms in hypertrophic cardiomyopathy (HCM) patients with heart failure with preserved ejection fraction (HFpEF) after percutaneous intramyocardial septal radiofrequency ablation (PIMSRA). METHODS: This study enrolled 31 adult HCM patients with HFpEF who underwent PIMSRA treatment. Electrocardiogram, imaging, and blood biochemical examinations were performed on these patients during a 6-month follow-up. RESULTS: Compared with the baseline, at 6 months after PIMSRA, patients showed significant reductions in peak left ventricular outflow tract pressure gradients (resting gradient: from a mean of 83.24 to 23.40 mmHg, p < 0.001; postexercise gradient: from a mean of 109.70 to 33.39 mmHg, p< 0.001). The interventricular septal thickness reduced from a mean of 22.90 to 17.48 mm, p < 0.001. The E/e' decreased from a median of 18.67 to 11.54, p < 0.001. The 6-minute walk distance (6MWD) increased from a mean of 359.03 to 435.81 m, p < 0.001. The Kansas City Cardiomyopathy Questionnaire Overall Summary Score (KCCQ OS) increased from a mean of 57.57 to 71.93, p < 0.001. The number of HFpEF patients diagnosed according to the European Society of Cardiology's Heart Failure Association HFA-PEFF score decreased from 31 to 23. None of the patients had new-onset bundle branch block or complete heart block after PIMSRA. CONCLUSION: PIMSRA is a safe and effective treatment. It can improve left ventricular diastolic function and quality of life in HCM patients.
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Wang et al. (2024) conducted an observational in Hypertrophic obstructive cardiomyopathy with HFpEF (n=31). Percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) vs. Baseline was evaluated on Resting peak left ventricular outflow tract pressure gradient (mmHg) (p=<0.001). Percutaneous intramyocardial septal radiofrequency ablation significantly reduced resting LVOT gradients from 83.24 to 23.40 mmHg (p<0.001) and improved diastolic function and symptoms at 6 months.
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