| Title: |
Aorto-mitral angle: an emerging indicator for successful alcohol septal ablation in hypertrophic obstructive cardiomyopathy - a pilot study |
| Authors: |
Sosdean, R; Pascalau, L; Mircea, M; Pescariu, S A; Voinescu, O; Lazar, M A; Sturza, A; Ionac, A; Luca, C T; Mornos, C |
| Source: |
European Heart Journal - Cardiovascular Imaging ; volume 26, issue Supplement_1 ; ISSN 2047-2404 2047-2412 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Background Approximately 10-20% of patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing alcohol septal ablation (ASA) exhibit a suboptimal response, despite accurate targeting of the septal artery. This suboptimal response may be due to structural and functional factors related to the mitral valve and left ventricular (LV) dimensions. Currently, there is a lack of specific parameters or cutoffs to predict ASA success. The aorto-mitral angle is crucial for predicting systolic anterior motion (SAM) in mitral valve repair surgery, but its relationship with ASA outcomes remains underexplored. Purpose This study aims to investigate the relationship between aorto-mitral angle values and the success of alcohol septal ablation, and to assess the impact of this parameter on ASA outcomes. Methods The study retrospectively included 23 HOCM patients who underwent ASA in our clinic, with data collected from thorough evaluations conducted before and at least six months after the procedure. The left ventricular outflow tract pressure gradient (LVOT PG) and other standard parameters were measured using transthoracic echocardiography. The aorto-mitral angle was assessed through three-dimensional data acquisition during transoesophageal echocardiography, analyzed offline using specific software (zoom 3D of the mitral valve, MVQ). Results Nineteen patients experienced successful ASA, defined as a >50% reduction in LVOT PG compared to baseline, while four patients had suboptimal results. There were no significant differences in baseline LV dimensions, LVOT PG, age, or comorbidities between the groups. The aorto-mitral angle was significantly higher in patients with successful ASA (138.21 ± 7.6 versus 115 ± 9.2 degrees, p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ehjci/jeae333.200 |
| Availability: |
https://doi.org/10.1093/ehjci/jeae333.200; https://academic.oup.com/ehjcimaging/article-pdf/26/Supplement_1/jeae333.200/61670089/jeae333.200.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.D3192ADC |
| Database: |
BASE |