Conservative versus invasive treatment in hypertrophic obstructive cardiomyopathy: an echocardiography study

AIM AND METHODS: The aim of our study was to compare the development of echocardiographic parameters and functional status of patients with hypertrophic obstructive cardiomyopathy (HOCM) treated conservatively (n = 41) or by alcohol septal ablation (ASA; n = 39). RESULTS: Left ventricular outflow tract gradient (LVOTG) decreased in the first year by 53.7 +/- 36.4 mmHg in ASA group versus 5.5 +/- 47.1 mmHg in conservatively treated group (p<0.001), in the third year by 53.1 +/- 41.4 mmHg versus 23.9 +/- 42.7 mmHg (p = NS) and in the fifth year, the reduction of LVOTG was 52.1 +/- 44.5 mmHg in ASA group and 3.0 +/- 63.2 mmHg in conservatively treated group (p<0.05). Change in NYHA class in the first year was 1.1 +/- 0.4 versus 0.1 +/- 0.5, in the third year 1.0 +/- 0.6 versus 0.1 +/- 0.4 and in the fifth year 0.8 +/- 0.5 versus 0.1 +/- 0.4 (all p<0.001). CONCLUSION: Our results showed for the first time that decline of LVOTG after ASA creates a favorable left ventricle remodeling and leads to significant improvement of functional status of HOCM patients in comparison with conservative treatment (Tab. 3, Fig. 2, Ref. 42).