Journal article
Usefulness of myocardial contrast echocardiographic quantification of risk area for predicting postprocedural complications in patients undergoing septal ethanol ablation for obstructive hypertrophic cardiomyopathy
The American journal of cardiology, v 94(12), pp 1515-1522
2004
PMID: 15589007
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Septal ethanol ablation (SEA) is an alternative to surgical myectomy in patients who have drug-refractory obstructive hypertrophic cardiomyopathy. However, permanent atrioventricular conduction block is seen more frequently with SEA. To determine whether septal infarction risk area (SIRA) predicts outcome in patients who have obstructive hypertrophic cardiomyopathy and are undergoing SEA, we evaluated 51 patients (mean age 60 ± 16, 53% women) who had a successful SEA at Toronto General Hospital (November 1998 to June 2003). Intracoronary myocardial contrast echocardiography that targeted the contact area between the septum and the anterior mitral leaflet was performed before ethanol injection. End-systolic myocardial contrast echocardiographic frames were color coded for better delineation of contrast borders, and myocardial contrast echocardiographic area was calculated by planimetry. Patients were assigned to 1 of 2 groups by median SIRA value (3.51 cm
2, range 0.4 to 7.8). The 2 groups did not differ significantly in age, medication before SEA, electrocardiographic characteristics, left ventricular function, left atrial diameter, volume of intracoronary ethanol injected, peak creatine kinase after ablation, and baseline and follow-up left ventricular outflow tract gradients at rest. Patients in the large SIRA group had greater hypertrophy and a larger septal artery than did patients in the small SIRA group. In the small SIRA group, 3 patients (11.5%) had pacemaker implantation; in the large SIRA group, 12 patients (48.0%) had complications after SEA (pacemaker in 5 patients, implantable defibrillator in 5 patients, death in 2 patients; p = 0.008). We conclude that patients who have hypertrophic cardiomyopathy with a small, well-localized SIRA benefit similarly from SEA as patients who have a larger SIRA but with significantly fewer serious complications.
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Details
- Title
- Usefulness of myocardial contrast echocardiographic quantification of risk area for predicting postprocedural complications in patients undergoing septal ethanol ablation for obstructive hypertrophic cardiomyopathy
- Creators
- Daniel Monakier - University Health NetworkAnna Woo - University Health NetworkTimothy Puri - Drexel UniversityLeonard Schwartz - University Health NetworkJohn Ross - University Health NetworkMichal Jamorski - University Health NetworkHua Yang - University Health NetworkZheng Liu - Drexel UniversityMani Vannan - Drexel UniversityE. Douglas Wigle - University Health NetworkHarry Rakowski - University Health NetworkJulia C Ross - Richard C. Goodwin College of Professional Studies (2001-)
- Publication Details
- The American journal of cardiology, v 94(12), pp 1515-1522
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Richard C. Goodwin College of Professional Studies
- Web of Science ID
- WOS:000225781500008
- Scopus ID
- 2-s2.0-13944284173
- Other Identifier
- 991019168538304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems