Changes in left ventricular filling and left atrial function six months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy
Key result
NSRT in HOCM is linked to increased LV passive filling and reduced LA size.
- P<0.01
- n=42
Why the study?
While nonsurgical septal reduction therapy reduces LVOT obstruction and improves symptoms in HOCM, its effect on LV passive filling volume, LA volumes, and LA function was unknown.
Does nonsurgical septal reduction therapy improve left ventricular filling and left atrial function in patients with hypertrophic obstructive cardiomyopathy?
Population
30 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 12 age-matched normal subjects
Comparison
Nonsurgical septal reduction therapy (NSRT) vs Baseline and age-matched normal subjects
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
Nonsurgical septal reduction therapy for HOCM improves LV passive filling and reduces LA size and mechanical burden at 6 months.
Key Points
- To assess alterations in left ventricular filling, left atrial volume, and left atrial mechanical function six months following nonsurgical septal reduction therapy in patients with hypertrophic obstructive cardiomyopathy.
- Assessed 30 patients with hypertrophic obstructive cardiomyopathy before and six months after nonsurgical septal reduction therapy, comparing atrial parameters to 12 age-matched normal controls.
- Performed treadmill exercise testing along with two-dimensional and Doppler echocardiography to evaluate left ventricular outflow tract gradient, mitral regurgitant volume, left ventricular pre-A pressure, and left atrial volumes.
- Calculated left atrial ejection force and kinetic energy noninvasively at baseline and follow-up.
- Six months post-procedure, New York Heart Association functional class improved, exercise duration increased (p < 0.05), and left ventricular outflow tract gradient, mitral regurgitant volume, and pre-A pressure were significantly reduced.
- Left ventricular passive filling volume increased significantly (p < 0.01), whereas left atrial volumes, ejection force, and kinetic energy significantly decreased (p < 0.01).
- Reductions in maximal left atrial volume correlated with drops in left ventricular pre-A pressure (r = 0.8, p < 0.05) and mitral regurgitant volume (r = 0.4, p < 0.05), while exercise duration increases correlated with passive filling volume increases (r = 0.85, p < 0.05).
Study Design
Type
Observational (n=42)
Structured PICO
Does nonsurgical septal reduction therapy improve left ventricular filling and left atrial function in patients with hypertrophic obstructive cardiomyopathy?
P
Population
30 patients with hypertrophic obstructive cardiomyopathy and 12 age-matched normal subjects evaluated before and 6 months after nonsurgical septal reduction therapy.
E
Exposure
Nonsurgical septal reduction therapy (NSRT)
C
Comparator
Baseline (pre-NSRT) and age-matched normal subjects
O
Outcome
Changes in left ventricular (LV) filling, left atrial (LA) volumes and function at six monthssurrogate
Main Result
p-value: p=<0.01
Nonsurgical septal reduction therapy for HOCM improves LV passive filling and reduces LA size and mechanical burden at 6 months.
Cite This Study
Nagueh et al. (1999) conducted an observational in Hypertrophic obstructive cardiomyopathy (HOCM) (n=42). Nonsurgical septal reduction therapy (NSRT) vs. Baseline and age-matched normal subjects was evaluated on Changes in left ventricular passive filling volume, left atrial volumes, ejection force, and kinetic energy (p=<0.01). Nonsurgical septal reduction therapy in HOCM patients significantly increased LV passive filling volume and reduced LA size, ejection force, and kinetic energy at 6 months (p<0.01).