title: Predictors of outcome after alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy. Special interest for the septal coronary anatomy.
abstract: BACKGROUND
  Alcohol septal ablation (ASA) provides symptomatic relief in most but not all patients with hypertrophic obstructive cardiomyopathy (HOCM). Therefore we investigated predictors of outcome after ASA.
  
  
  METHODS
  Clinical, echocardiographic, angiographic and procedural characteristics were analysed in 113 consecutive patients. Successful ASA was defined as NYHA ≤ 2 with improvement of at least 1 class combined with a resting gradient < 30 mmHg and provoked gradient < 50 mmHg at 4-month follow-up.
  
  
  RESULTS
  In 37 patients ASA was not successful. In multivariate analysis, baseline gradient (OR 1.06 (1.01-1.11) per 5 mmHg, p = 0.024) and distance to the ablated septal branch (OR 1.09 (1.03-1.16) per mm, p = 0.004) were predictors of unsuccessful outcome. The combined presence of a non-ablated septal branch and a distance ≥ 19 mm to the ablated branch was a predictor of unsuccessful outcome (OR 5.88 (2.06-16.7), p < 0.001).
  
  
  CONCLUSIONS
  Baseline gradient and a greater distance from the origin of the left anterior descending artery to the ablated septal branch combined with a non-ablated proximal septal branch are associated with an unsuccessful outcome after ASA.
authors.affiliation: Department of Cardiology, Martini Hospital, Van Swietenplein 1, 9728 NT, Groningen, the Netherlands, r.c.steggerda@mzh.nl.
authors.forename: R C
authors.initials: RC
authors.lastname: Steggerda
authors.forename: J C
authors.initials: JC
authors.lastname: Balt
authors.forename: K
authors.initials: K
authors.lastname: Damman
authors.forename: M P
authors.initials: MP
authors.lastname: van den Berg
authors.forename: J M
authors.initials: JM
authors.lastname: Ten Berg