Conservative versus invasive treatment in hypertrophic obstructive cardiomyopathy: an echocardiography study.
The aim of our study was to compare the development of echocardiographic parameters and functional status of patients with hypertrophic obstructive cardiomyopathy (HOCM) treated conservatively (n = 41) or by alcohol septal ablation (ASA; n = 39).



Left ventricular outflow tract gradient (LVOTG) decreased in the first year by 53.7±36.4 mmHg in ASA group versus 5.5±47.1 mmHg in conservatively treated group (p<0.001), in the third year by 53.1±41.4 mmHg versus 23.9±42.7 mmHg (p = NS) and in the fifth year, the reduction of LVOTG was 52.1±44.5 mmHg in ASA group and 3.0±63.2 mmHg in conservatively treated group (p<0.05).Change in NYHA class in the first year was -1.1±0.4 versus 0.1±0.5, in the third year -1.0±0.6 versus 0.1±0.4 and in the fifth year -0.8±0.5 versus 0.1±0.4 (all p<0.001).



Our results showed for the first time that decline of LVOTG after ASA creates a favorable left ventricle remodeling and leads to significant improvement of functional status of HOCM patients in comparison with conservative treatment (Tab. 3, Fig. 2, Ref. 42).
T
T
Honek
J
J
Krejci
J
J
Machal
L
L
Groch
J
J
Sitar
J
J
Meluzin
L
L
Spinarova
D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000601:surgery*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000379:methods*; D000072700:Conservative Treatment; D004452:Echocardiography; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006346:Heart Septum / Q000187:drug effects / Q000601:surgery*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*
D000431:Ethanol
alcohol septal ablation; conservative treatment; hypertrophic obstructive cardiomyopathy; invasive treatment echocardiography.