Alcohol septal ablation in hypertrophic cardiomyopathy: For which patients?
Alexandru AchimAdela Mihaela SerbanStefan Dan Cezar MotGregor LeibundgutMadalin MarcUlrich SigwartPublished in: ESC heart failure (2023)
Percutaneous and surgical therapies for septal reduction for hypertrophic cardiomyopathy have been going head-to-head for the past 20 years with similar outcomes and mortality rates, although contemporary myectomy seems to materialize its superiority. However, on closer analysis, the external validity of studies advocating myectomy does not translate to all centres. The aim of this review was to examine the most recent data on septal reduction therapy and to attempt to phenotype the appropriate patient for each of the two treatments. The key to similar low mortality rates between ventricular septal myectomy and alcohol septal ablation appears to be proper patient selection performed in high volume clinical environments. Furthermore, we analyse the role of mavacampten (the recently approved cardiac myosin inhibitor) in replacing or complementing the two septal reduction therapies.
Keyphrases
- hypertrophic cardiomyopathy
- left ventricular
- heart failure
- end stage renal disease
- case report
- chronic kidney disease
- ejection fraction
- radiofrequency ablation
- cardiovascular events
- newly diagnosed
- prognostic factors
- type diabetes
- skeletal muscle
- deep learning
- bone marrow
- machine learning
- mesenchymal stem cells
- metabolic syndrome
- big data
- atrial fibrillation
- binding protein
- chemotherapy induced