title: Age-related hemodynamic and morphologic differences in patients undergoing alcohol septal ablation for hypertrophic obstructive cardiomyopathy.
abstract: BACKGROUND
  Alcohol septal ablation (ASA) decreases the left ventricular (LV) outflow gradient and relieves symptoms in patients with highly symptomatic hypertrophic obstructive cardiomyopathy (HOCM). The aim of this study was to evaluate the early course of hemodynamic, morphologic and clinical changes in younger and elderly patients.
  
  
  RESULTS
  Forty-four consecutive patients (age, 24-81 years) underwent the ASA procedure for HOCM. Clinical and echocardiographic data were obtained at baseline and periodically up to 12 months after ASA. There was a significant correlation between septum thickness and age at baseline and in the early post procedural period (p = 0.004 at baseline, p = 0.0033 days postoperative, p = 0.0193 weeks pos operative). The dependence of septal thickness on the duration of follow-up (p < 0.001) was significantly influenced by age (p = 0.026), which retained statistical significance after multivariate adjustment (p = 0.031). A decrease in the gradient of the LV outflow was identified in all age-related groups of patients (p < 0.001). After multivariate adjustment, there was a significant influence of age (p = 0.003) and creatine kinase-MB peak (p = 0.016) on the course of outflow gradient reduction.
  
  
  CONCLUSIONS
  ASA is an effective treatment option for patients with HOCM, irrespective of their age. Younger patients are characterized by a thicker basal septum at baseline and a slower hemodynamic improvement within the early post procedural period.
authors.affiliation: Department of Cardiology, University Hospital Motol, Prague, Czech Republic. veselka.josef@seznam.cz
authors.forename: Josef
authors.initials: J
authors.lastname: Veselka
authors.forename: Radka
authors.initials: R
authors.lastname: Duchonová
authors.forename: Jana
authors.initials: J
authors.lastname: Pálenícková
authors.forename: David
authors.initials: D
authors.lastname: Zemánek
authors.forename: Premysl
authors.initials: P
authors.lastname: Sváb
authors.forename: Petr
authors.initials: P
authors.lastname: Hájek
authors.forename: Martin
authors.initials: M
authors.lastname: Maly
authors.forename: Petr
authors.initials: P
authors.lastname: Blásko
authors.forename: David
authors.initials: D
authors.lastname: Tesar
authors.forename: Pavel
authors.initials: P
authors.lastname: Cervinka
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation; D002492:Central Nervous System Depressants / Q000008:administration & dosage*; D000431:Ethanol / Q000008:administration & dosage*; D006346:Heart Septum / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol