Response by Maurizi et al to Letter Regarding Article, “Long-Term Outcomes After Septal Reduction Therapies in Obstructive Hypertrophic Cardiomyopathy: Insights From the SHARE Registry”

We appreciate the thoughtful comments from Zhangand Zeng regarding our recent study on the long-termoutcomes of septal reduction therapy (SRT) in obstruc-tive hypertrophic cardiomyopathy.1 We are pleased thatour work has stimulated further discussion, and we wel-come the opportunity to address their points.Most published literature addressing the outcomeafter SRT originate from a small number of high-volumesurgical and interventional hypertrophic cardiomyopathyreferral centers or from insurance claims data with onlyin-hospital mortality data.2,3 Given this, we considered itessential to evaluate outcomes in high-volume clinicalcenters that are not primarily interventional. While includ-ing broader populations, such as those treated in com-munity settings, may provide epidemiological insights, itremains a complex issue. Current guidelines recommendthat SRT should be performed primarily in specializedreferral centers, where comprehensive clinical manage-ment, careful patient selection, and procedural expertiseare key determinants of perioperative success.