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Long term exercise capacity in patients with hypertrophic cardiomyopathy treated with percutaneous transluminal septal myocardial ablation
Author(s) -
Malek Lukasz A.,
Chojnowska Lidia,
Klopotowski Mariusz,
Maczynska Renata,
Demkow Marcin,
Witkowski Adam,
Kusmierczyk Beata,
Piotrowicz Ewa,
Konka Marek,
Dabrowski Maciej,
Ruzyllo Witold
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.09.005
Subject(s) - medicine , cardiology , percutaneous , heart failure , ventricular outflow tract , cardiomyopathy , ablation , hypertrophic cardiomyopathy , heart disease , vo2 max , heart rate , blood pressure
Background: In hypertrophic obstructive cardiomyopathy, percutaneous transluminal septal myocardial ablation (PTSMA) improves functional capacity in the short term. However, long term functional capacity is unknown. Aim: To assess the long term exercise capacity of patients with hypertrophic obstructive cardiomyopathy undergoing PTSMA. Methods: Twenty three patients (56.5% male, mean age 44.5±13.6 years) who underwent PTSMA were included. All patients had also undergone a symptom limited cardiopulmonary exercise treadmill test before the procedure, then after 3 months (early follow‐up) and after a mean 7.2±1.0 years (long term follow‐up). Results: Before PTSMA, mean maximal pressure gradient in the left outflow tract (LVOTGmax) was 82±29 mmHg, 17 patients had NYHA functional class ≥ III and peak oxygen uptake (pVO 2 ) was 18±4 ml/kg/min. PTSMA led to a reduction in mean LVOTGmax (to 29 ± 19 mmHg. p <.0001), improvement of heart failure symptoms (NYHA≥III in 1 patient, p <.0001) and an increase of pVO 2 (to 22±6 ml/kg/min, p =.0002) at short term. LVOTGmax, functional class and pVO 2 did not change significantly during long term follow‐up compared to early follow‐up. However, there was a continuous improvement in percentage predicted pVO 2 over time. Conclusions: In patients with hypertrophic obstructive cardiomyopathy and symptoms of heart failure, PTSMA leads to stable long term improvement of objectively measured exercise capacity.