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August 2, 2026

Coronary Flow in Hypertrophic Obstructive Cardiomyopathy-Immediate Effects of Alcohol Septal Ablation.

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Why the study?

Hypertrophic cardiomyopathy is associated with coronary microvascular dysfunction showing variable pathophysiologic mechanisms and variable reversibility acutely and chronically following alcohol septal ablation.

Does alcohol septal ablation improve immediate absolute coronary blood flow and coronary flow reserve in patients with hypertrophic obstructive cardiomyopathy?

Comparison

Immediately after ASA vs before ASA

Design

Single-center observational study

Follow-up

Immediately after ASA

Key result

Alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy produced no significant immediate change in mean coronary flow reserve (2.31 before vs. 2.35 after ASA; p=0.808).

Authors

VMVojko V MisevicAGAna N GolocevacKKKosta S Krupnikovic

Discussion

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Member takes

Overview

No immediate change in coronary flow reserve after alcohol septal ablation; leaves open whether delayed effects or clinical outcomes differ in hypertrophic obstructive cardiomyopathy.

Key Points

  • This research aims to assess the immediate effects of alcohol septal ablation on coronary blood flow in patients with hypertrophic obstructive cardiomyopathy.
  • Patients without obstructive coronary artery disease undergoing alcohol septal ablation were enrolled.
  • Absolute coronary blood flow was measured using continuous thermodilution before and after alcohol septal ablation.
  • Coronary flow reserve and resistance were calculated from the measured blood flow.
  • Left ventricular outflow tract gradient decreased significantly from 101 mmHg to 19 mmHg (p < 0.01).
  • Average resting and hyperemic coronary blood flow showed no significant changes (p > 0.05).
  • Thirteen out of twenty-three patients experienced a 10% improvement in coronary flow reserve, indicating a potential benefit from the procedure.

Study Design

Type

Observational (n=23)

Multicenter

No

Structured PICO

Does alcohol septal ablation improve immediate absolute coronary blood flow and coronary flow reserve in patients with hypertrophic obstructive cardiomyopathy?

P
Population
23 patients (mean age 57.9 years, 47.8% female) with hypertrophic obstructive cardiomyopathy and no obstructive coronary artery disease undergoing alcohol septal ablation.
E
Exposure
Alcohol septal ablation (ASA)
C
Comparator
Pre-ablation baseline (immediate before ASA)
O
Outcome
Immediate changes in absolute coronary blood flow (Q), coronary flow reserve (CFR), and resistance (R) measured using continuous thermodilutionsurrogate

Main Result

Absolute Event Rate: 2.35% vs 2.31%

p-value: p=0.808

Alcohol septal ablation in hypertrophic obstructive cardiomyopathy does not produce immediate uniform improvements in coronary microvascular function, though a subset with lower baseline flow may experience improvement.

Cite This Study

Misevic et al. (2026) conducted an observational in Hypertrophic Obstructive Cardiomyopathy (n=23). Alcohol Septal Ablation vs. Pre-ablation baseline was evaluated on Coronary flow reserve (CFR) (p=0.808). Alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy produced no significant immediate change in mean coronary flow reserve (2.31 before vs. 2.35 after ASA; p=0.808).

synapsesocial.com/papers/6a6eeb101b0468a7eeab3e83https://doi.org/10.1002/ccd.70791
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