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Effects of alcohol septal ablation on left ventricular diastolic filling patterns in obstructive hypertrophic cardiomyopathy

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Abstract

Alcohol septal ablation (ASA) has been shown to improve left ventricular (LV) diastolic function in patients with obstructive hypertrophic cardiomyopathy (HCM). However, its beneficial effect on diastolic function assessed by cardiac magnetic resonance (CMR) has not been reported. We investigated the mid-term changes of diastolic function by CMR combined with echocardiography in HCM patients after ASA at a median of 14-month follow-up. CMR parameters of diastolic function including peak filling rate (PFR), and time to peak filling rate (TPFR) were evaluated in 43 patients (aged 48 ± 9 years). LV diastolic function improved significantly measured by echocardiography with the decrease in ratio of transmitral early LV filling velocity (E) to early diastolic mitral lateral annular velocity (E′) (14.20 ± 1.17 to 11.58 ± 1.16, p < 0.001) and E-wave deceleration time (194.04 ± 19.30 to 168.45 ± 12.58 ms, p < 0.001). PFR increased significantly with associated decrease in TPFR after ASA (both p < 0.001) at follow-up. Furthermore, patients with larger decrease in LVOT gradients had a greater improvement of LV diastolic function, as measured by the reduction of E/E′ (p < 0.001) and increase of PFR (p < 0.001). In conclusion, this study demonstrated that successful ASA results in both echocardiographic and CMR indices of diastolic function improvement after ASA at 14-month follow-up. ASA therapy can significantly reduce LVOT gradient and mitral regurgitation, both of which may contribute to the improvement of diastolic function.

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Acknowledgments

We thank Medis medical imaging system and QMass software (Netherlands) for the support.

Conflict of interest

There is no potential conflict of interest to disclose for any of the co-authors.

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    Authors and Affiliations

    1. State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, XiCheng District, Beijing, 100037, China

      You-Zhou Chen, Jian-Song Yuan, Feng-Huan Hu, Jin-Gang Cui, Wei-Xian Yang & Shu-Bin Qiao

    2. State Key Laboratory of Cardiovascular Disease, Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

      Fu-Jian Duan & Hao Wang

    3. State Key Laboratory of Cardiovascular Disease, Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

      Yan Zhang

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    1. You-Zhou Chen
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    Correspondence to Shu-Bin Qiao.

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    Y.-Z. Chen and F.-J. Duan contributed equally as first authors to this work.

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    Chen, YZ., Duan, FJ., Yuan, JS. et al. Effects of alcohol septal ablation on left ventricular diastolic filling patterns in obstructive hypertrophic cardiomyopathy. Heart Vessels 31, 744–751 (2016). https://doi.org/10.1007/s00380-015-0656-2

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    • DOI: https://doi.org/10.1007/s00380-015-0656-2

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