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Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip

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Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip. / Schäfer, Ulrich; Frerker, Christian; Thielsen, Thomas; Schewel, Dimitry; Bader, Ralf; Kuck, Karl-Heinz; Kreidel, Felix.

In: EUROINTERVENTION, Vol. 11, No. 8, 12.2015, p. 942-947.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schäfer, U, Frerker, C, Thielsen, T, Schewel, D, Bader, R, Kuck, K-H & Kreidel, F 2015, 'Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip', EUROINTERVENTION, vol. 11, no. 8, pp. 942-947. https://doi.org/10.4244/EIJY14M08_13

APA

Schäfer, U., Frerker, C., Thielsen, T., Schewel, D., Bader, R., Kuck, K-H., & Kreidel, F. (2015). Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip. EUROINTERVENTION, 11(8), 942-947. https://doi.org/10.4244/EIJY14M08_13

Vancouver

Schäfer U, Frerker C, Thielsen T, Schewel D, Bader R, Kuck K-H et al. Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip. EUROINTERVENTION. 2015 Dec;11(8):942-947. https://doi.org/10.4244/EIJY14M08_13

Bibtex

@article{a74c67c9256d46b9b341c02b647ebc7f,
title = "Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip",
abstract = "AIMS: Hypertrophic obstructive cardiomyopathy (HOCM) with left ventricular outflow tract obstruction frequently involves a systolic anterior motion (SAM) of the anterior mitral leaflet. We hypothesised that SAM could be a new target for MitraClip therapy.METHODS AND RESULTS: Three patients with HOCM were chosen for MitraClip therapy, due to significant SAM with subsequent mitral regurgitation. Invasive haemodynamic studies (right heart catheterisation, simultaneous transaortic pressure recording, and administration of nitroglycerine) were performed before and after MitraClip implantation, and a six-week follow-up was undertaken. MitraClip implantation was successfully performed with significant reduction of mitral regurgitation and SAM in all patients. Basal peak gradients (before clip: 65±25.5 mmHg; after clip: 7.7±5.0 mmHg) as well as provoked pressure gradients (before clip: 145.3±8.1 mmHg; after clip: 23.2±7.6 mmHg) were significantly reduced after MitraClip implantation. Right heart catheterisation data did not reveal major changes. At six-week follow-up, all patients presented in a persistently improved clinical state (NYHA Class I-II) with insignificant residual MR and continuously reduced LVOT gradients.CONCLUSIONS: This is the first catheter-based study targeting primarily a SAM in HOCM to reduce LVOT obstruction. The results prove the concept that SAM is more than an epiphenomenon in HOCM. Thus, SAM-induced obstruction might be a valuable target for the MitraClip.",
keywords = "Aged, Cardiac Catheterization/instrumentation, Cardiomyopathy, Hypertrophic/complications, Echocardiography, Doppler, Color, Echocardiography, Transesophageal, Female, Hemodynamics, Humans, Male, Mitral Valve/diagnostic imaging, Mitral Valve Insufficiency/diagnosis, Systole, Time Factors, Treatment Outcome, Ventricular Function, Left, Ventricular Outflow Obstruction/diagnosis",
author = "Ulrich Sch{\"a}fer and Christian Frerker and Thomas Thielsen and Dimitry Schewel and Ralf Bader and Karl-Heinz Kuck and Felix Kreidel",
year = "2015",
month = dec,
doi = "10.4244/EIJY14M08_13",
language = "English",
volume = "11",
pages = "942--947",
journal = "EUROINTERVENTION",
issn = "1774-024X",
publisher = "EUROPA EDITION",
number = "8",

}

RIS

TY - JOUR

T1 - Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip

AU - Schäfer, Ulrich

AU - Frerker, Christian

AU - Thielsen, Thomas

AU - Schewel, Dimitry

AU - Bader, Ralf

AU - Kuck, Karl-Heinz

AU - Kreidel, Felix

PY - 2015/12

Y1 - 2015/12

N2 - AIMS: Hypertrophic obstructive cardiomyopathy (HOCM) with left ventricular outflow tract obstruction frequently involves a systolic anterior motion (SAM) of the anterior mitral leaflet. We hypothesised that SAM could be a new target for MitraClip therapy.METHODS AND RESULTS: Three patients with HOCM were chosen for MitraClip therapy, due to significant SAM with subsequent mitral regurgitation. Invasive haemodynamic studies (right heart catheterisation, simultaneous transaortic pressure recording, and administration of nitroglycerine) were performed before and after MitraClip implantation, and a six-week follow-up was undertaken. MitraClip implantation was successfully performed with significant reduction of mitral regurgitation and SAM in all patients. Basal peak gradients (before clip: 65±25.5 mmHg; after clip: 7.7±5.0 mmHg) as well as provoked pressure gradients (before clip: 145.3±8.1 mmHg; after clip: 23.2±7.6 mmHg) were significantly reduced after MitraClip implantation. Right heart catheterisation data did not reveal major changes. At six-week follow-up, all patients presented in a persistently improved clinical state (NYHA Class I-II) with insignificant residual MR and continuously reduced LVOT gradients.CONCLUSIONS: This is the first catheter-based study targeting primarily a SAM in HOCM to reduce LVOT obstruction. The results prove the concept that SAM is more than an epiphenomenon in HOCM. Thus, SAM-induced obstruction might be a valuable target for the MitraClip.

AB - AIMS: Hypertrophic obstructive cardiomyopathy (HOCM) with left ventricular outflow tract obstruction frequently involves a systolic anterior motion (SAM) of the anterior mitral leaflet. We hypothesised that SAM could be a new target for MitraClip therapy.METHODS AND RESULTS: Three patients with HOCM were chosen for MitraClip therapy, due to significant SAM with subsequent mitral regurgitation. Invasive haemodynamic studies (right heart catheterisation, simultaneous transaortic pressure recording, and administration of nitroglycerine) were performed before and after MitraClip implantation, and a six-week follow-up was undertaken. MitraClip implantation was successfully performed with significant reduction of mitral regurgitation and SAM in all patients. Basal peak gradients (before clip: 65±25.5 mmHg; after clip: 7.7±5.0 mmHg) as well as provoked pressure gradients (before clip: 145.3±8.1 mmHg; after clip: 23.2±7.6 mmHg) were significantly reduced after MitraClip implantation. Right heart catheterisation data did not reveal major changes. At six-week follow-up, all patients presented in a persistently improved clinical state (NYHA Class I-II) with insignificant residual MR and continuously reduced LVOT gradients.CONCLUSIONS: This is the first catheter-based study targeting primarily a SAM in HOCM to reduce LVOT obstruction. The results prove the concept that SAM is more than an epiphenomenon in HOCM. Thus, SAM-induced obstruction might be a valuable target for the MitraClip.

KW - Aged

KW - Cardiac Catheterization/instrumentation

KW - Cardiomyopathy, Hypertrophic/complications

KW - Echocardiography, Doppler, Color

KW - Echocardiography, Transesophageal

KW - Female

KW - Hemodynamics

KW - Humans

KW - Male

KW - Mitral Valve/diagnostic imaging

KW - Mitral Valve Insufficiency/diagnosis

KW - Systole

KW - Time Factors

KW - Treatment Outcome

KW - Ventricular Function, Left

KW - Ventricular Outflow Obstruction/diagnosis

U2 - 10.4244/EIJY14M08_13

DO - 10.4244/EIJY14M08_13

M3 - SCORING: Journal article

C2 - 25169590

VL - 11

SP - 942

EP - 947

JO - EUROINTERVENTION

JF - EUROINTERVENTION

SN - 1774-024X

IS - 8

ER -