Di-san junyi daxue xuebao (Mar 2020)
Decreasing amplitude of left ventricular outflow tract gradient and its influencing factors after alcohol septal ablation
Abstract
Objective To analyze the decreasing amplitude of left ventricular outflow tract gradient(LVOTG) and its influencing factors after alcohol septal ablation(ASA) in treatment of hypertrophic obstructive cardiomyopathy(HOCM). Methods A total of 58 HOCM patients treated by ASA in our hospital from August 2011 to August 2019 were recruited in this study. The changes of echocardiography before and after ASA(a median follow-up period of 34 d) were compared to evaluate the decreasing amplitude of LVOTG after surgery. According to whether the LVOTG was decreased by 50%, the patients were divided into the significant LVOTG decline group(LVOTG decline ≥50%) and the non-significant decline group(LVOTG decline < 50%). The clinical data were compared between the 2 groups. The independent influential factors of significant LVOTG decline were analyzed, and receiver operation characteristic(ROC) curve analysis was also performed for the influencing factors. Results The LVOTG of the 58 patients was decreased from 90.77±33.38 mmHg preoperatively to 46.13±39.31 mmHg(P < 0.05). The interventricular septum thickness, left atrial diameter, mitral regurgitation area and systolic anterior motion were all significantly reduced after surgery (P < 0.05). Multivariate logistic regression analysis indicated that alcohol dose(OR=3.222, 95%CI: 1.345~7.717, P=0.009) was an independent influencing factor of significant LVOTG decline in short term, with the area under curve(AUC) of 0.707(95%CI: 0.573~0.841, P=0.009). Conclusion ASA can effectively reduce LVOTG in HOCM patients. And the higher the alcohol dose is, the more significant the decreasing amplitude is.
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