Zaporožskij Medicinskij Žurnal (Feb 2020)

The results of alcohol septal ablation in patients with hypertrophic cardiomiopathy and arterial hypertension

  • K. V. Rudenko,
  • L. O. Nevmerzhytska,
  • O. Yu. Dudnyk,
  • S. M. Fanta,
  • P. A. Danchenko,
  • I. M. Kurpaianidi,
  • V. V. Lazoryshynets

DOI
https://doi.org/10.14739/2310-1210.2020.1.194463
Journal volume & issue
Vol. 22, no. 1
pp. 4 – 10

Abstract

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Objective: to study the impact of arterial hypertension on the results of treatment in patients with hypertrophic cardiomyopathy (HCM) with alcohol septal ablation (ASA) in short-term and long-term follow-up. Materials and methods. The study included 115 patients with HCM who underwent primary isolated ASA during 2009–2018 years at Amosov National Institute of Cardiovascular Surgery of the NAMS of Ukraine and were divided into 2 groups: 44 (38.3 %) with accompanying arterial hypertension (AH) and 71 (61.7 %) without it. Results. Statistically significant decreases in the systolic pressure gradient, mitral regurgitation, NYHA functional class in both groups within short- and long-term periods were proved. There was a statistically significant increase in complete right-bundle branch blocks in both groups, whereas the quantity of implanted pacemakers due to complete AV-block in patients after ASA did not increase statistically. Among the patients with AH, 31 patients (70.4 %) had good result, 3 (6.8 %) – relatively unsatisfactory, 10 (22.7 %) – unsatisfactory in the short-term period. Among the patients without AH, the good result had 42 patients (59.1 %), relatively unsatisfactory – 3 (4.2 %), unsatisfactory – 26 (36.6 %). In the long-term period, among the patients with AH, 32 (80.0 %) had good hemodynamic result, 1 (2.5 %) – relatively unsatisfactory, 7 (17.5 %) – unsatisfactory; among the patients without AH – 43 (64.2 %), 4 (6.0 %) and 20 (29.8 %) patients, respectively. There was no statistically significant difference in results between two groups neither in short-term, nor in the long-term period. Conclusions. The results of the study showed that comorbid arterial hypertension in patient with obstructive hypertrophic cardiomyopathy who underwent ASA does not affect the short- and long-term parameters of the systolic pressure gradient in left ventricular outflow tract, mitral insufficiency, interventricular septum thickness, NYHA functional class, rate of non-fatal outcomes (complete right-bundle branch block, complete AV-block), mortality.

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