Effect of echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation on the Lown classification in patients with hypertrophic obstructive cardiomyopathy
10.3760/cma.j.cn131148-20221010-00679
- VernacularTitle:超声引导下经皮心肌内室间隔射频消融术治疗梗阻性肥厚型心肌病对Lown分级的影响
- Author:
Ying LI
1
;
Shengjun TA
;
Jing WANG
;
Jing LI
;
Xumei OU
;
Changting LIANG
;
Changhui LEI
;
Jiani LIU
;
Lu YAO
;
Liwen LIU
Author Information
1. 空军军医大学第一附属医院（西京医院）超声医学科 空军军医大学第一附属医院（西京医院）肥厚型心肌病国际合作中心 陕西省肥厚型心肌病多学科会诊中心 西京医院肥厚型心肌病多学科诊治与遗传咨询中心，西安 710032
- Keywords:
Cardiomyopathy, hypertrophic;
Percutaneous intramyocardial septal radiofrequency ablation;
Lown classification
- From:
Chinese Journal of Ultrasonography
2023;32(4):288-294
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) guided by echocardiography on the Lown classification of ventricular arrhythmias in patients with hypertrophic obstructive cardiomyopathy (HOCM).Methods:A total of 85 patients with HOCM who received PIMSRA treatment at Xijing Hospital of Air Force Military Medical University from May 2017 to October 2019 were retrospectively selected. All patients underwent 24-hour Holter examinations before and 1 year after PIMSRA to obtain parameters related to Lown classification. The changes in Lown grades after PIMSRA were analyzed. The patients were divided into improved group and unimproved group according to whether there was significant improvement in Lowen′s grades, and the difference of the parameters related were compared. The influencing factors of the changes in Lown classification were analyzed.Results:Compared with before PIMSRA, there was a significant improvement in the Lown classification after PIMSRA ( P=0.001). The patients with Lown grade Ⅰ increased significantly ( P=0.001), and the patients with grade Ⅲ decreased significantly ( P=0.005). There were no significant changes in patients with Lown grades 0, Ⅱ, and Ⅳ (all P>0.05). The proportion of patients with family history of hypertrophic cardiomyopathy (HCM), the baseline Lown classes, the reduction rate of the maximum left ventricular wall thickness and the reduction rate of the provocative left ventricular outflow tract gradient (LVOTG) were higher in the improved group than the unimproved group (all P<0.05). Multivariate Logistic regression results showed that HCM family history ( OR=3.95, 95% CI=1.34-11.64, P=0.013), baseline Lown classes ( OR=2.01, 95% CI=1.25-3.22, P=0.004) and the reduction rate of the provocative LVOTG gradient ( OR=1.02, 95% CI=1.00-1.04, P=0.041) were independent factors of postoperative Lown classification improvement. Conclusions:The Lown classes of HOCM patients after PIMSRA is significantly improved.HCM family history, the baseline Lown classes, and the reduction rate of postoperative provocative LVOTG are independent influencing factors for the improvement of Lown grade.
