Efficacy Of Percutaneous Transluminal Septal Myocardial Ablation With Different Dosage Of Alcohol In Hypertrophic Obstructive Cardiomyopathy

Objective:To observe the efficacy of percutaneous transluminal septal myocardial ablation(PTSMA)with different dosage of alcohol in patients with drug-refractory hypertrophic obstructive Cardiomyopathy(HOCM).Methods:32 patients with HOCM were enrolled and classified into two groups according to the dosage of alcohol during PTSMA:small dosage group with 1.0-2.0ml alcohol,and larger dosage group with 2.5-4.0ml alcohol.Left ventricular outflow-tract gradient(LVOTG)was measured before and after the PTSMA procedure using cardiac catheter.UCG were used to record the LVOTG before and 3 months after ablation.Results:The average LVOTG of group with small dosage alcohol was 72.2±10.6 mmHg before the procedure,and 28.1 ±7.9 mmHg after the procedure(P<0.01).The larger dosage group was 74.3± 12.0 mmHg and 26.6±6.9 mmHg(P<0.01)respectively.Troponin I in larger dosage group was significant elevated comparing to small dosage group,(17.0±10.6)ng·ml-1 to(7.0±2.9)ng·ml-1,P<0.05.There were significant differences in intraventricular septal thickness(IVS)and PGmax between before and 3 months after ablation in both groups(P<0.01),but there was no significant differences between the groups.Conclusion:PTSMA with small dosage of alcohol is effective and safer for symptomatic patients with HOCM.