Yasuo Amano 1 , Mitsunobu Kitamura 2 , Fumi Yamada 3 , Kumiko Aita 3 , Morimasa Takayama 4 , Masaki Tachi 3 , Shinichiro Kumita 3 Show Affiliations »
Abstract
BACKGROUND: The clinical significance of microvascular obstruction (MO) in hypertrophic cardiomyopathy (HOCM) after percutaneous transluminal septal myocardial ablation (PTSMA) remains unknown. PURPOSE: To assess the relationship between the location of MO and the improvement in symptoms and pressure gradient after PTSMA in patients with HOCM. MATERIAL AND METHODS: Twenty-three patients with HOCM underwent MRI within 24 weeks after PTSMA. The MO was defined visually as the hypointense region adjacent to the left or right ventricular cavity, which was surrounded by myocardial infarction. The location of MO and improvement in clinical symptoms and pressure gradient at 3-6 months follow-up were assessed. RESULTS: MO was observed in 16 patients who underwent MRI within 7 weeks after PTSMA. Left-sided MO was observed in 12 patients, and right-sided MO was observed in four patients. Improvement in clinical symptoms and reduction in the pressure gradient were not sufficient in the patients with right-sided MO, while PTSMA was effective in the patients with the left-sided MO. CONCLUSION: The location of MO identified by MRI may be related to the effectiveness of PTSMA at the short-term follow-up. The left-sided MO is related to complete improvement in clinical symptoms and pressure gradients. © The Foundation Acta Radiologica 2014.
BACKGROUND: The clinical significance of microvascular obstruction (MO) in hypertrophic cardiomyopathy (HOCM) after percutaneous transluminal septal myocardial ablation (PTSMA) remains unknown. PURPOSE: To assess the relationship between the location of MO and the improvement in symptoms and pressure gradient after PTSMA in patients with HOCM. MATERIAL AND METHODS: Twenty-three patients with HOCM underwent MRI within 24 weeks after PTSMA. The MO was defined visually as the hypointense region adjacent to the left or right ventricular cavity, which was surrounded by myocardial infarction . The location of MO and improvement in clinical symptoms and pressure gradient at 3-6 months follow-up were assessed. RESULTS: MO was observed in 16 patients who underwent MRI within 7 weeks after PTSMA. Left-sided MO was observed in 12 patients , and right-sided MO was observed in four patients . Improvement in clinical symptoms and reduction in the pressure gradient were not sufficient in the patients with right-sided MO, while PTSMA was effective in the patients with the left-sided MO. CONCLUSION: The location of MO identified by MRI may be related to the effectiveness of PTSMA at the short-term follow-up. The left-sided MO is related to complete improvement in clinical symptoms and pressure gradients. © The Foundation Acta Radiologica 2014.
Entities: Disease
Species
Keywords:
Magnetic resonance imaging (MRI); hypertrophic obstructive cardiomyopathy; microvascular obstruction; percutaneous transmural septal myocardial ablation
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Year: 2014
PMID： 25414371 DOI： 10.1177/0284185114559871
Source DB: PubMed Journal: Acta Radiol ISSN： 0284-1851 Impact factor: 1.990