Clinical Research in Cardiology

, Volume 107, Issue 6, pp 479–486 | Cite as

Risk marker profiles in patients treated with percutaneous septal ablation for symptomatic hypertrophic obstructive cardiomyopathy

  • Amelie Burghardt
  • Frank van Buuren
  • Zisis Dimitriadis
  • Tim Grübbel
  • Hubert Seggewiss
  • Smita Scholtz
  • Dieter Horstkotte
  • Lothar Faber
Original Paper


Background and study objective

Different studies have shown a good long-term survival with improvement of symptoms and hemodynamics after percutaneous septal ablation (PTSMA), similar to myectomy considered to be the therapeutic “gold standard” for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Furthermore, desobliteration of left ventricular (LV) outflow may modify features of the disease considered to be risk-relevant, such as magnitude of LV hypertrophy, outflow gradient, and left atrial (LA) size. The aim oft this study was to examine predictors of long-term mortality in a large cohort of patients with HOCM treated with PTSMA.

Methods and results

497 consecutive patients with symptomatic HOCM (mean age 55.4 ± 14.4 years, NYHA class: 2.9 ± 0.4) who underwent PTSMA between 1996 and 2014 were studied. Periprocedural mortality was 1% (five patients). During a follow-up time of 64.5 ± 53.2 months (range 0.1–207), 51 patients died, of these 25 due to cardiovascular problems, while 26 deaths were attributed to non-cardiac causes. Overall survival rates were 89.4% (± 1.7) after 5 and 80.6% (± 2.7) after 10 years. Among the baseline variables, advanced age, recurrent syncope, and magnitude of LV thickening were risk markers correlated to long-term post-procedural survival. The only mortality predictor that could be identified during follow-up was post-procedural NYHA class. Neither the other classical HCM risk markers nor other clinical or echocardiographic parameters predicted cardiac or all-cause mortality in this cohort.


Our findings suggest that the risk profile after septal ablation may differ from that of HOCM patients without an outflow desobliteration.


Hypertrophic obstructive cardiomyopathy HOCM ICD Left ventricular outflow tract gradient Percutaneous septal ablation Sudden cardiac death 





Canadian Cardiovascular Society


Creatine Kinase


Continuous wave Doppler




European Society of Cardiology


Fractional shortening


Hypertrophic (obstructive/non-obstructive) cardiomyopathy


Hazard ratio


Implantable cardioverter defibrillator


Intraventricular septum


Left atrium


Left anterior descending artery


Left ventricle


Left ventricular end-diastolic diameter


Left ventricular outflow tract


Left ventricular outflow tract gradient


Left ventricular outflow tract obstruction


Magnetic resonance imaging


Non-sustained ventricular tachycardia


New York Heart Association


Percutaneous transluminal septal myocardial ablation


Systolic anterior movement of the mitral valve


Sudden cardiac death



All authors have participated in the work and agree with the content of the article which contains data from the MD thesis of A. B. Parts of this work have been presented as abstract during the Annual Meeting of the German Cardiac Society 2015.

Compliance with ethical standards

Ethical standards

The study protocol was approved by the institutional review board (Ref.-#: 14/2014) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Amelie Burghardt
    • 1
  • Frank van Buuren
    • 1
  • Zisis Dimitriadis
    • 1
  • Tim Grübbel
    • 1
  • Hubert Seggewiss
    • 1
    • 2
  • Smita Scholtz
    • 1
  • Dieter Horstkotte
    • 1
  • Lothar Faber
    • 1
  1. 1.Clinic for Cardiology, Herz- und Diabeteszentrum NRWRuhr-Universität BochumBad OeynhausenGermany
  2. 2.Medical Clinic ILeopoldina HospitalSchweinfurtGermany

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