Alcohol septal ablation for obstructive hypertrophic cardiomyopathy: ultra-low dose of alcohol (1 ml) is still effective
Language English Country Japan Media print-electronic
Document type Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Time Factors MeSH
- Adult MeSH
- Ethanol administration & dosage MeSH
- Cardiomyopathy, Hypertrophic diagnostic imaging physiopathology therapy MeSH
- Injections, Intralesional MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Myocardium MeSH
- Follow-Up Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Cardiac Catheterization methods MeSH
- Ultrasonography MeSH
- Treatment Outcome MeSH
- Dose-Response Relationship, Drug MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
- Names of Substances
- Ethanol MeSH
Echo-guided alcohol septal ablation (ASA) is an alternative treatment for highly symptomatic patients with obstructive hypertrophic cardiomyopathy (HOCM). Previous reports suggest that a low dose of alcohol (1.5-2 ml) is as effective as the classic dose (2-4 ml) used in the past. Because a larger infarct might be associated with a potential long-term risk, in this pilot study we wanted to determine whether an ultra-low dose of alcohol (1 ml) would be effective in the mid-term follow-up. Seventy patients (55+/-13 years, range 24-81 years, septum thickness <31 mm) with a highly symptomatic HOCM receiving maximum medical therapy were enrolled. Thirty-five consecutive patients (group I) have been treated with an ultra-low alcohol dose (1.0+/-0.1 ml) and compared with a control group II of 35 patients treated by the same medical team using the classic alcohol dose (2.5+/-0.8 ml) in the past. At 6-month follow-up, both groups of patients improved in dyspnea (2.9+/-0.6 vs 1.5+/-0.5 New York Heart Association [NYHA] class for group I; P<0.01, and 2.5+/-0.7 vs 1.4+/-0.4 NYHA class for group II; P<0.01) and angina (2.1+/-1 vs 0.6+/-0.8 Canadian Cardiovascular Society [CCS] class for group I; P<0.01, and 2.1+/-0.9 vs 0.7+/-0.7 CCS class for group II; P<0.01). There was a significant decrease in left ventricular (LV) ejection fraction (P<0.05), septum thickness (P<0.01), and LV outflow gradient (P<0.01) in both groups of patients. However, there was no significant difference with regard to the extent of symptomatic or echocardiographic changes and complications between both groups. These results suggest that the ultra-low dose of alcohol (1 ml) is still effective in the treatment of the majority of HOCM patients without extreme septum hypertrophy (<31 mm).
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Circulation. 2007 Jul 10;116(2):207-16; discussion 216 PubMed
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Eur J Echocardiogr. 2004 Oct;5(5):347-55 PubMed
Swiss Med Wkly. 2007 Dec 1;137(47-48):657-9 PubMed
Eur Heart J. 2006 Aug;27(15):1805-10 PubMed
Echocardiography. 2005 Feb;22(2):105-9 PubMed
Heart Vessels. 1992;7(1):52-5 PubMed
Circulation. 2005 May 17;111(19):2503-8 PubMed
Tex Heart Inst J. 2007;34(3):336-46 PubMed
Circulation. 2006 Nov 21;114(21):2232-9 PubMed
Nat Clin Pract Cardiovasc Med. 2007 Oct;4(10):570-6 PubMed
Circ J. 2006 Dec;70(12):1550-2 PubMed
Lancet. 2000 Feb 5;355(9202):425-6 PubMed
Nat Clin Pract Cardiovasc Med. 2007 Sep;4(9):503-12 PubMed
Heart Vessels. 2007 Sep;22(5):322-7 PubMed
Catheter Cardiovasc Interv. 2005 Jun;65(2):313-4 PubMed
Circulation. 1996 Aug 1;94(3):467-71 PubMed
Lancet. 1995 Jul 22;346(8969):211-4 PubMed
J Interv Cardiol. 2006 Aug;19(4):319-27 PubMed
Am J Cardiol. 2005 Mar 1;95(5):675-8 PubMed
Med Sci Monit. 2007 Apr;13(4):RA62-8 PubMed
Eur Heart J. 2003 Nov;24(21):1965-91 PubMed
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