Introduction
Methods
Patients
Definitions
Alcohol septal ablation
Echocardiography
Coronary angiography
Statistical analysis
Results
Variables | Outcome after ASA |
P-value | |
---|---|---|---|
Successful (n = 76) | Unsuccessful (n = 37) | ||
Age (years) | 56 ± 17 | 57 ± 14 | 0.93 |
Male sex (% (n)) | 55 (41) | 44 (17) | 0.32 |
NYHA functional class | 2.9 ± 0.4 | 2.8 ± 0.7 | 0.78 |
Angina functional class | 1.9 ± 0.4 | 2.0 ± 0.4 | 0.33 |
Syncope (% (n)) | 23 (17) | 18 (7) | 0.71 |
β-blocker or Ca-blocker (% (n)) | 83 (63) | 78 (29) | 0.52 |
Previous pacemaker (% (n)) | 5 (4) | 0 (0) | 0.36 |
Max CK (U/l) | 1294 ± 461 | 1431 ± 793 | 0.34 |
Max CK Mb (U/l) | 201 ± 124 | 167 ± 59 | 0.051 |
Hospital stay, days | 5.6 ± 4 | 6.3 ± 5 | 0.49 |
Angiographic findings | |||
- Non-ablated branch present (% (n)) | 26 (19) | 50 (19) | 0.01 |
- Distance to ablated branch (mm) | 16 ± 7 | 20 ± 8 | 0.006 |
- Diameter ablated branch (mm) | 1.7 ± 0.4 | 1.6 ± 0.5 | 0.25 |
- Diameter non-ablated branch (mm) | 1.0 ± 0.3 | 1.1 ± 0.4 | 0.32 |
- Amount of alcohol (ml) | 2.4 ± 0.7 | 2.3 ± 0.5 | 0.55 |
- Number of ablated branches | 1.2 ± 0.4 | 1.2 ± 0.4 | 0.99 |
- Invasive gradient pre ASA (mmHg) | 83 ± 32 | 95 ± 35 | 0.08 |
Echocardiographic findings
Variables | Outcome after ASA |
P value | |
---|---|---|---|
Baseline | Successful (n = 76) | Unsuccessful (n = 37) | |
Septal thickness (mm) | 22 ± 5 | 22 ± 5 | 0.95 |
Posterior wall thickness (mm) | 15 ± 3 | 16 ± 3 | 0.71 |
End-diastolic volume (ml) | 77 ± 25 | 74 ± 26 | 0.63 |
End-systolic volume (ml) | 18 ± 11 | 16 ± 7 | 0.20 |
Ejection fraction (%) | 76 ± ? | 78 ± ? | 0.41 |
LVOT min (mm) | 14 ± 5 | 13 ± 5 | 0.66 |
Degree of MI | 1.5 ± 1.0 | 1.7 ± 1.1 | 0.50 |
Degree of SAM | 2.9 ± 0.6 | 3.0 ± 0.6 | 0.14 |
Resting gradient (mmHg) | 43 ± 40 | 63 ± 46 | 0.026 |
Provoked gradient (mmHg) | 107 ± 53 | 126 ± 67 | 0.15 |
At 4-month follow-up | |||
Septal thickness (mm) | 20 ± 4 | 20 ± 4 | 0.43 |
Posterior wall thickness (mm) | 14 ± 3 | 14 ± 3 | 0.62 |
End-diastolic volume (ml) | 81 ± 27 | 74 ± 24 | 0.14 |
End-systolic volume (ml) | 23 ± 15 | 18 ± 9 | 0.053 |
Ejection fraction (%) | 74 ± 10 | 77 ± 10 | 0.16 |
LVOT min (mm) | 19 ± 4 | 15 ± 5 | <0.001 |
LVOT min, increase | 5.6 ± 4 | 1.7 ±3 | <0.001 |
Degree of MI | 0.5 ± 0.7 | 1.0 ± 1.0 | 0.020 |
Degree of SAM | 1.0 ± 0.9 | 2.2 ± 1.1 | <0.001 |
Akinetic basal septum (% (n)) | 72 (55) | 19 (7) | <0.001 |
Without sparing basal septum (% (n)) | 58 (45) | 17 (6) | <0.001 |
Resting gradient (mmHg) | 12 ± 7 | 41 ± 38 | <0.001 |
Provoked gradient (mmHg) | 17 ± 10 | 91 ± 53 | <0.001 |
Decrease provoked gradient (mmHg) | 91 ± 53 | 35 ± 60 | <0.001 |
Angiographic findings
Predictors of unsuccessful outcome
Variable | Univariate | Multivariate | ||
---|---|---|---|---|
OR (95 % CI) |
P-value | OR (95 % CI) |
P-value | |
Age | 1.00 (0.97–1.03) | 0.87 | ||
Sex (males) | 1.50 (0.68–3.32) | 0.32 | ||
Baseline resting gradient (per 5 mmHg) | 1.06 (1.01–1.11) | 0.024 | 1.06 (1.01–1.11) | 0.024 |
Distance to ablated branch (per mm) | 1.08 (1.03–1.55) | 0.005 | 1.09 (1.03–1.16) | 0.004 |
Non-ablated branch present | 2.85 (1.24–6.53) | 0.013 |
Variable | N | Univariate | Mulitvariate | ||
---|---|---|---|---|---|
OR (95 % CI) |
P-value | OR (95 % CI) |
P-value | ||
Baseline resting gradient (per 5 mmHg) | 1.06 (1.01–1.11) | 0.024 | 1.05 (1.00–1.10) | 0.061 | |
Distance vs non-ablated branch | |||||
- Distance < 19 mm, non-ablated branch not present | 54 | 1.00 | – | 1.00 | – |
- Distance ≥ 19 mm, non-ablated branch not present | 21 | 0.99 (0.30–3.21) | 0.98 | 1.14 (0.33–3.88) | 0.83 |
- Distance < 19 mm, non-ablated branch present | 11 | 0.32 (0.36–2.70) | 0.29 | 0.40 (0.05–3.52) | 0.41 |
- Distance ≥ 19 mm, non-ablated branch present | 27 | 5.36 (1.97–14.57) | 0.001 | 5.88 (2.06–16.74) | 0.001 |