AS-130: Short-Term Morbidity and Mortality Follow-Up of Newly Diagnosed Systolic Heart Failure...

Cardiomyopathy

(Abstract nos. AS-129–AS-130)

AS-129Early Complications of Low-Dose, Echo-Guided Alcohol SeptalAblation. Josef Veselka, David Zemanek, Pavol Tomasov,Stanislava Homolova. University Hospital Motol, Prague, CzechRepublic.

Background: Alcohol septal ablation (ASA) is a catheter-based inter-vention that has been used as an alternative to surgical myectomy inhighly symptomatic patients with hypertrophic obstructive cardiomy-opathy (HOCM).

Methods: This retrospective study was designed to evaluate theincidence of major complications in the midterm follow-up of low-dose(1.0–2.5 mL of ethanol), echo-guided alcohol septal ablation.

Results: Enrolled in the study were 101 consecutive patients (56 �15 years) with highly symptomatic HOCM. At 6 months, there was asignificant decrease in resting outflow gradient accompanied by reduc-tion in basal septal diameter and improvement in symptoms (p �0.01).Two patients (2%) experienced procedural ventricular tachycardiasterminated by electrical cardioversion. Eighty-seven patients (86%)underwent an uneventful postprocedural hospital stay. The postproce-dural complete heart block occurred in 10 patients (10%), and subse-quent permanent pacemaker was implanted in 4 cases (4%). Sustainedventricular arrhythmias requiring electrical cardioversion occurred in 4patients (4%) within postprocedural hospital stay. Subsequently, animplantable cardioverter defibrillator was not used in any of thesecases. The patients were repeatedly examined by Holter electrocardio-gram monitoring, and in the midterm follow-up (6–50 months), theystayed asymptomatic and without ventricular arrhythmia.

Conclusion: This study demonstrates the same early incidence ofcomplete heart block requiring permanent pacemaker implantation

(4%) and sustained ventricular arrhythmias following low-dose, echo-guided ASA.

AS-130Short-Term Morbidity and Mortality Follow-Up of NewlyDiagnosed Systolic Heart Failure Egyptian Patients after FirstAdmission. Basem Enany, Mustafa Alshaikha, Adel Hasanin,Ahmed Nasar. Ainshams University, Cairo, Egypt.

Background: Despite advances in therapy for heart failure (HF),outcomes remain relatively poor. This study was done to follow up theclinical course of systolic HF in Egyptian patients for 3 months aftertheir first admission for HF, including morbidity and mortality.

Methods: Sixty-nine newly diagnosed systolic HF patients wereadmitted to Ainshams University Hospital, Police Hospital, in Cairo.Seven patients did not undergo follow-up, 5 patients were excludedbecause they received previous treatment mostly related to HF, 3patients were excluded for having serious diseases with poor prognosis,and 5 patients refused to participate in the study. Thus, 49 patients wereincluded. Morbidity and mortality were identified by prospective fol-low-up of all patients.

Results: Of the 49 patients evaluated, 15 were women. Mean agewas 61.6 � 15.2 years. Mean length of stay during the first admissionwas 11.8 � 5.5 days. The 1 and 3 months mortality rates were 4.1%and 6.1%, respectively. All-cause deaths were cardiovascular in origin;66.6% of these were sudden cardiac deaths, and 33.3% were due toventricular arrhythmias. Mortality rate was higher in elderly patients�70 years (p � 0.0214), low systolic blood pressure (p � 0.0189), lowdiastolic blood pressure (p � 0.0186), and high blood urea patients(p � 0.032). Of the 46 survivors, 30.4% experienced at least 1 hospitalreadmission during follow-up. Readmission was associated more withthe following variables: low left ventricular ejection fraction % (p�0.001), poor compliance with diet and medication (p � 0.045), andhigh random blood glucose level (p � 0.035).

Conclusion: Despite the advances in treatment and diagnosticprocedures, HF still carries a grave prognosis. Length of hospital stayfor stabilization is still long. Morbidity and mortality rates are still high.There is still room for improvement in diagnostic and treatment facil-ities to reduce these rates. Patient education is important because mostdo not adhere to diet and drugs recommendations, and this is the mostcommon cause of readmission in Egypt.

The American Journal of Cardiology� APRIL 28–30 2010 ANGIOPLASTY SUMMIT ABSTRACTS/E-Poster 55B

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ABSTRACTS

Wednesday, April 28 - Friday, April 30, 2010 (E-Poster Abstract Zone)