Medical treatment of hypertrophic cardiomyopathy

Sherrid, Mark V.; Gunsburg, David Z.; Sharma, Ajay

doi:10.1007/s11886-000-0012-7

Cited by 10 publications

(3 citation statements)

References 28 publications

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“…The majority of patients have an abnormally thickened ventricular septum, which could lead to systolic anterior motion of the mitral valve and obstruction of the left ventricular outflow tract (LVOT) [ 1 ]. Initial pharmacological therapy including beta-blockers and verapamil produces a negative inotropic effect to relieve the obstruction [ 2 , 3 ]. In patients who are refractory to medical treatments, septal reduction therapy (SRT) is indicated.…”

Section: Introductionmentioning

confidence: 99%

The Risk of Ventricular Arrhythmias between Alcohol Septal Ablation and Septal Myectomy in Hypertrophic Cardiomyopathy: A Meta-Analysis on Septal Reduction Therapy

Tang¹,

Liu²,

Li³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Alcohol septal ablation (ASA) has been more commonly applied in medical refractory hypertrophic obstructive cardiomyopathy (HOCM) compared with septal myectomy (SM), however its potential to create a proarrhythmic substrate is increased. Methods: A systematic search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to October 2020. Fixed or random effects models were used to estimate the risk ratios (RR) for ventricular arrhythmia events or other outcomes between the SM and ASA cohorts. Results: Twenty studies with 8025 patients were included. Pool analysis showed that the incidence of ventricular tachycardia (VT)/ventricular fibrillation (VF), which included appropriate implantable cardioverter defibrillator (ICD) intervention, was significantly higher in the ASA cohort than that in the SM cohort (ASA vs SM: 10% (345/3312) vs 5% (161/3227) (RR = 1.98, 95% CI (confidence interval), 1.65-2.37; p < 0.00001, I 2 = 0%). In both groups, more than 90% of VT/VF events occurred in the early phase (during the procedure, during hospitalization or within 30 days after the procedure) (ASA: 94.20%; SM: 94.41%). Further subgroup analysis also showed that the ASA group had a higher incidence of VT/VF in both the early phase (RR = 1.94, 95% CI, 1.61-2.33; p < 0.0001, I 2 = 0%) and the late phase (RR = 2.80, 95% CI, 1.00-7.89; p = 0.05, I 2 = 33%). Furthermore, although the risks of sudden cardiac death (SCD) were similar between the ASA and SM groups, a higher incidence of sudden cardiac arrest (SCA), which included SCD and resuscitated SCA, was observed in the ASA group (RR = 2.30, 95% CI, 1.35-3.94; p = 0.002, I 2 = 0%). Conclusions: In patients with HOCM, those who received ASA showed a higher incidence of VF/VT and SCD combined with resuscitated SCA. The majority of VT/VF occurred in the early phase.

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Section: Introductionmentioning

confidence: 99%

The Risk of Ventricular Arrhythmias between Alcohol Septal Ablation and Septal Myectomy in Hypertrophic Cardiomyopathy: A Meta-Analysis on Septal Reduction Therapy

Tang¹,

Liu²,

Li³

et al. 2022

Rev. Cardiovasc. Med.

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“…Early studies with Ca^'-entry blockers indicate beneficial short-term effects on diastolic function, but only minor improvement after 6 month (considered to be long term in this study) [81]. Many studies focus on the reduction of the outflow tract obstruction, but it is questionable how important this is for symptoms and prognosis [81][82][83][84]-A retrospective study in the UK concluded improved survival in HCM children treated with high dose betaadrenoceptor blockers [83]. It has been shown that the outflow tract gradient can be reduced by left or biventricular pacing, septal alcohol injection or partial septal resection, with short term relieve of symptoms.…”

Section: Therapy In Hcmmentioning

confidence: 98%

“…Up to now two loci for JLNS have been identified. Homozygous and compound heterozygous mutations in both the KCNOl gene and KCNEl gene represent JLNSl and JLNS2 respectively [46,84,85]. In JLNS homozygous mutations (the human knock-out) or compound heterozygous mutations lead to complete loss of the functional cardiac potassium current 1^ explaining the severe cardio-auditory syndrome [45,46,86].…”

Section: -5 Mutations In Ion Channel Genes Are Causative For Cardiac Events In Lqtsmentioning

confidence: 99%

Genetic causes of fatal ventricular arrhythmias : the long QT syndrome and familial hypertrophic cardiomyopathy

Jongbloed¹

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