Key result
Percutaneous transluminal septal myocardial ablation significantly reduced the index of maximum left atrial volume from 93.6 to 82.6 mL/m2 (p=0.035) in patients with hypertrophic obstructive cardiomyopathy.
Why the study?
Left atrial volume measurement is important for prognosis in HOCM, and the utility of follow-up cardiac MDCT to evaluate PTSMA effects on LA volume needed examination.
Does percutaneous transluminal septal myocardial ablation reduce left atrial volume as measured by MDCT in patients with drug-refractory HOCM?
Cohort (n=16)
Single-blind (outcome assessors)
No
Does percutaneous transluminal septal myocardial ablation reduce left atrial volume as measured by MDCT in patients with drug-refractory HOCM?
Cardiac MDCT is a useful tool for evaluating the reduction of left atrial volume following percutaneous transluminal septal myocardial ablation in patients with drug-refractory HOCM, showing comparable results to echocardiography.
Answers are grounded in this paper and cite their sources.
PTSMA was associated with LA volume reduction in HOCM; leaves open MDCT's role for monitoring pending prospective trials.
OBJECTIVE: In patients with hypertrophic obstructive cardiomyopathy (HOCM), left atrial (LA) volume measurement is very important to provide prognostic information. Recent studies demonstrated that multidetector CT (MDCT) is useful to assess the changes in LA volume. Our aim was to examine the utility of a follow-up cardiac MDCT for long-term evaluation of the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on LA volume. METHODS: We studied a consecutive cohort of 20 patients with drug-refractory symptomatic HOCM after PTSMA. We evaluated LA volume analyses with cardiac MDCT on patients who underwent PTSMA as compared to echocardiography. RESULTS: Before PTSMA, 75% of all patients had heart failure-associated symptoms in the New York Heart Association functional class III/IV. All patients experienced relief from heart failure-associated symptoms after PTSMA. Cardiac MDCT showed significant reduction in the index of maximum LA volume during follow-up compared to before PTSMA in the same way as in echocardiography (93.6±34.1 mL/m(2) vs 82.6±35.3 mL/m(2), p=0.035). A Bland-Altman plot showed small mean differences and limits of agreement in the measurements of the index of maximum LA volume before and after PTSMA between echocardiography and MDCT. CONCLUSIONS: The follow-up cardiac MDCT was a useful tool to evaluate the effectiveness of PTSMA on reduction of LA volume. Cardiac MDCT might provide comparable measurements of the LA volume in patients with drug-refractory symptomatic HOCM before and after PTSMA compared to echocardiography.
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Maekawa et al. (2016) conducted a cohort in Hypertrophic obstructive cardiomyopathy (n=16). Percutaneous transluminal septal myocardial ablation vs. Baseline (before ablation) was evaluated on Index of maximum left atrial volume (LAVImax) measured by cardiac MDCT (p=0.035). Percutaneous transluminal septal myocardial ablation significantly reduced the index of maximum left atrial volume from 93.6 to 82.6 mL/m2 (p=0.035) in patients with hypertrophic obstructive cardiomyopathy.
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