BACKGROUND In patients with disabling symptoms caused by hypertrophic obstructive cardiomyopathy (HOCM), echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) could be a less invasive treatment option. OBJECTIVES This study aimed to investigate the safety and efficacy of the PIMSRA for left ventricular outflow tract (LVOT) gradient reduction in HOCM. METHODS The study enrolled 15 patients with HOCM. These patients underwent electrocardiography, imaging, and blood biochemistry examination over 6 months of follow-up. RESULTS At 6 months of follow-up, patients showed significant reductions in peak LVOT gradients (resting gradient: from 88.00 [66.00] mm Hg to 11.00 [6.00] mm Hg; p = 0.001; stress-induced gradient: from 117.00 [81.00] mm Hg to 25.00 [20.00] mm Hg; p = 0.005) and interventricular septum (IVS) thickness (anterior IVS: from 25.00 [21.00] mm to 14.00 [12.00] mm; p = 0.001; posterior IVS: from 24.00 [21.00] mm to 14.00 [11.50] mm; p = 0.001). The reductions in IVS thickness and LVOT gradients were associated with improvement in New York Heart Association functional classification (from 3.00 [2.00] to 1.00 [1.00]; p < 0.001), total exercise time (from 6.00 [5.50] min to 9.00 [8.00] min; p = 0.007), and pro B-type natriuretic peptide levels (from 924.00 [370.45] pg/ml to 137.45 [75.73] pg/ml; p = 0.028). No patient had bundle branch block or complete heart block. CONCLUSIONS PIMSRA is a safe and effective treatment approach for severe, symptomatic HOCM and results in sustained improvement in exercise capacity, persistent reduction in LVOT gradient, and sustained improvement in cardiac function.

中文翻译：

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肥厚性梗阻性心肌病经皮心肌间隔射频消融术

背景 对于肥厚性梗阻性心肌病 (HOCM) 引起的致残症状的患者，超声心动图引导的经皮心肌间隔射频消融 (PIMSRA) 可能是一种侵入性较小的治疗选择。目的 本研究旨在探讨 PIMSRA 在 HOCM 中降低左心室流出道 (LVOT) 梯度的安全性和有效性。方法 该研究招募了 15 名 HOCM 患者。这些患者在 6 个月的随访中接受了心电图、影像学和血液生化检查。结果 在 6 个月的随访中，患者的 LVOT 梯度峰值显着降低（静息梯度：从 88.00 [66.00] mm Hg 到 11.00 [6.00] mm Hg；p = 0.001；压力引起的梯度：从 117.00 [81.00]毫米汞柱至 25.00 [20.00] 毫米汞柱；p = 0。005) 和室间隔 (IVS) 厚度（前部 IVS：从 25.00 [21.00] 毫米到 14.00 [12.00] 毫米；p = 0.001；后部 IVS：从 24.00 [21.00] 毫米到 14.00 [11.00] 毫米；14.00 [11.00] 毫米）。 . IVS 厚度和 LVOT 梯度的降低与纽约心脏协会功能分类（从 3.00 [2.00] 到 1.00 [1.00]；p < 0.001）、总运动时间（从 6.00 [5.50] 分钟到 9.00 [8.00] 分钟）的改善有关] 分钟；p = 0.007)，以及前 B 型利钠肽水平（从 924.00 [370.45] pg/ml 到 137.45 [75.73] pg/ml；p = 0.028）。没有患者出现束支传导阻滞或完全性心脏传导阻滞。结论 PIMSRA 是一种安全有效的治疗严重、有症状的 HOCM 的方法，可以持续改善运动能力、持续降低 LVOT 梯度和持续改善心功能。