{
    "abstract": "Septal reduction therapy (SRT) provides substantial symptomatic improvement in patients with obstructive hypertrophic cardiomyopathy (HCM). However, long-term disease course after SRT and predictors of adverse outcomes have not been systematically examined.\nData from 13 high clinical volume HCM centers from the international SHARE (Sarcomeric Human Cardiomyopathy Registry) were analyzed. Patients were followed from the time of SRT until last follow-up or occurrence of heart failure (HF) composite outcome (cardiac transplantation, implantation of a left ventricular assist device, left ventricular ejection fraction <35%, development of New York Heart Association class III or IV symptoms), ventricular arrhythmias composite outcome (sudden cardiac death, resuscitated cardiac arrest, or appropriate implantable cardioverter defibrillator therapy), or HCM-related death. Cox proportional hazards models were used to identify predictors of outcome.\nOf the 10 225 patients in SHARE, 1832 (18%; 968 [53%] male) underwent SRT, including 455 (25%) with alcohol septal ablation and 1377 (75%) with septal myectomy. The periprocedural 30-day mortality rate was 0.4% (8 of 1832) and 1499 of 1565 (92%) had a maximal left ventricular outflow tract gradient <50 mm Hg at 1 year. After 6.8 years (range, 3.4-9.8 years; 12 565 person-years) from SRT, 77 (4%) experienced HCM-related death (0.6% per year), 236 (13%) a composite HF outcome (1.9% per year), and 87 (5%) a composite ventricular arrhythmia outcome (0.7% per year). Among adults, older age at SRT was associated with a higher incidence of HCM death (hazard ratio, 1.22 [95 CI, 1.1-1.3]; \nSuccessful short- and long-term relief of outflow tract obstruction was observed in experienced multidisciplinary HCM centers. A subset of patients progressed to develop HF, but event-free survival at 10 years was 83% and ventricular arrhythmias were rare. Older age, female sex, and SRT during childhood were associated with a greater risk of developing HF.",
    "authors": [
        {
            "affiliation": "Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy (N.M., C.F., I.O.).\nService of Cardiology, University Hospital of Lausanne, Switzerland (N.M., P.A., I.S.).",
            "firstname": "Niccol\u00f2",
            "initials": "N",
            "lastname": "Maurizi"
        },
        {
            "affiliation": "Service of Cardiology, University Hospital of Lausanne, Switzerland (N.M., P.A., I.S.).",
            "firstname": "Panagiotis",
            "initials": "P",
            "lastname": "Antiochos"
        },
        {
            "affiliation": "Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., S.M.D.).",
            "firstname": "Anjali",
            "initials": "A",
            "lastname": "Owens"
        },
        {
            "affiliation": "Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (N.L., C.Y.H.).",
            "firstname": "Neal",
            "initials": "N",
            "lastname": "Lakdwala"
        },
        {
            "affiliation": "Departments of Internal Medicine (S.S., A.S.H.), University of Michigan, Ann Arbor.",
            "firstname": "Sara",
            "initials": "S",
            "lastname": "Saberi"
        },
        {
            "affiliation": "Pediatrics (M.W.R.), University of Michigan, Ann Arbor.",
            "firstname": "Mark W",
            "initials": "MW",
            "lastname": "Russell"
        },
        {
            "affiliation": "Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy (N.M., C.F., I.O.).\nDepartment of Advanced and Surgical Sciences, University of Campania-Luigi Vanvitelli, Naples, Italy (C.F.).",
            "firstname": "Carlo",
            "initials": "C",
            "lastname": "Fumagalli"
        },
        {
            "affiliation": "Service of Cardiology, University Hospital of Lausanne, Switzerland (N.M., P.A., I.S.).",
            "firstname": "Ioannis",
            "initials": "I",
            "lastname": "Skalidis"
        },
        {
            "affiliation": "Department of Pediatrics, Children's Hospital of Philadelphia, PA (K.Y.L., R.L., J.R.).",
            "firstname": "Kimberly Y",
            "initials": "KY",
            "lastname": "Lin"
        },
        {
            "affiliation": "Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., S.M.D.).",
            "firstname": "Ashwin S",
            "initials": "AS",
            "lastname": "Nathan"
        },
        {
            "affiliation": "Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., S.M.D.).",
            "firstname": "Alejandro",
            "initials": "A",
            "lastname": "De Feria Alsina"
        },
        {
            "affiliation": "Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., S.M.D.).",
            "firstname": "Nosheen",
            "initials": "N",
            "lastname": "Reza"
        },
        {
            "affiliation": "Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT (J.C.S.).",
            "firstname": "John C",
            "initials": "JC",
            "lastname": "Stendahl"
        },
        {
            "affiliation": "Center for Cardiovascular Genetics, Boston Children's Hospital, MA (D.A.).",
            "firstname": "Dominic",
            "initials": "D",
            "lastname": "Abrams"
        },
        {
            "affiliation": "Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, New South Wales, Australia (C.S.).\nSydney Medical School Faculty of Medicine and Health, The University of Sydney, Australia (C.S.).\nDepartment of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia (C.S.).",
            "firstname": "Christopher",
            "initials": "C",
            "lastname": "Semsarian"
        },
        {
            "affiliation": "Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA (B.C.).",
            "firstname": "Brian",
            "initials": "B",
            "lastname": "Clagget"
        },
        {
            "affiliation": "Department of Pediatrics, Children's Hospital of Philadelphia, PA (K.Y.L., R.L., J.R.).",
            "firstname": "Rachel",
            "initials": "R",
            "lastname": "Lampert"
        },
        {
            "affiliation": "Center for Inherited Cardiovascular Disease, Falk Cardiovascular Research Building, Stanford Medicine, CA (M.W., V.N.P., E.A.).",
            "firstname": "Matthew",
            "initials": "M",
            "lastname": "Wheeler"
        },
        {
            "affiliation": "Center for Inherited Cardiovascular Disease, Falk Cardiovascular Research Building, Stanford Medicine, CA (M.W., V.N.P., E.A.).",
            "firstname": "Victoria N",
            "initials": "VN",
            "lastname": "Parikh"
        },
        {
            "affiliation": "Center for Inherited Cardiovascular Disease, Falk Cardiovascular Research Building, Stanford Medicine, CA (M.W., V.N.P., E.A.).",
            "firstname": "Euan",
            "initials": "E",
            "lastname": "Ashley"
        },
        {
            "affiliation": "Erasmus Medical Center, Cardiovascular Institute, Thoraxcenter, Department of Cardiology, Rotterdam, the Netherlands (M.M.).",
            "firstname": "Michelle",
            "initials": "M",
            "lastname": "Michels"
        },
        {
            "affiliation": "Department of Pediatrics, Children's Hospital of Philadelphia, PA (K.Y.L., R.L., J.R.).",
            "firstname": "Joseph",
            "initials": "J",
            "lastname": "Rossano"
        },
        {
            "affiliation": "Heart Institute, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, OH (T.D.R.).",
            "firstname": "Thomas D",
            "initials": "TD",
            "lastname": "Ryan"
        },
        {
            "affiliation": "Genomics and Inherited Diseases Program, Garvan Institute of Medical Research and UNSW Sydney, Australia (J.I.).",
            "firstname": "Jodie",
            "initials": "J",
            "lastname": "Ingles"
        },
        {
            "affiliation": "National Heart and Lung Institute and Royal Brompton Cardiovascular Research Centre, Imperial College London, UK (J.W.).",
            "firstname": "James",
            "initials": "J",
            "lastname": "Ware"
        },
        {
            "affiliation": "Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (N.L., C.Y.H.).",
            "firstname": "Carolyn Y",
            "initials": "CY",
            "lastname": "Ho"
        },
        {
            "affiliation": "Departments of Internal Medicine (S.S., A.S.H.), University of Michigan, Ann Arbor.",
            "firstname": "Adam S",
            "initials": "AS",
            "lastname": "Helms"
        },
        {
            "affiliation": "Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., S.M.D.).",
            "firstname": "Sharlene M",
            "initials": "SM",
            "lastname": "Day"
        },
        {
            "affiliation": "Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy (N.M., C.F., I.O.).\nCardiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy (I.O.).",
            "firstname": "Iacopo",
            "initials": "I",
            "lastname": "Olivotto"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1161/CIRCULATIONAHA.124.069378\n10.1161/CIRCRESAHA.116.309348",
    "journal": "Circulation",
    "keywords": [
        "cardiomyopathy, hypertrophic",
        "heart failure",
        "hypertrophy, left ventricular",
        "myectomy"
    ],
    "methods": null,
    "publication_date": "2024-10-02",
    "pubmed_id": "39355918\n30110588\n17088454\n12540642\n16754630\n19589436\n37048808\n37804245\n16053960\n18591440\n17707185\n15678046\n18187386\n12323162\n16027255\n30810698\n30545446\n17712363\n35483751\n27438114\n37183831\n17723936\n30297972\n37622657\n38718139\n30681346\n31296080\n28912182\n35965115\n20026827\n30213605\n37407153\n16053962\n37961906\n38938243\n19007692\n37116851\n29088344\n31370956",
    "results": "Of the 10 225 patients in SHARE, 1832 (18%; 968 [53%] male) underwent SRT, including 455 (25%) with alcohol septal ablation and 1377 (75%) with septal myectomy. The periprocedural 30-day mortality rate was 0.4% (8 of 1832) and 1499 of 1565 (92%) had a maximal left ventricular outflow tract gradient <50 mm Hg at 1 year. After 6.8 years (range, 3.4-9.8 years; 12 565 person-years) from SRT, 77 (4%) experienced HCM-related death (0.6% per year), 236 (13%) a composite HF outcome (1.9% per year), and 87 (5%) a composite ventricular arrhythmia outcome (0.7% per year). Among adults, older age at SRT was associated with a higher incidence of HCM death (hazard ratio, 1.22 [95 CI, 1.1-1.3]; ",
    "title": "Long-Term Outcomes After Septal Reduction Therapies in Obstructive Hypertrophic Cardiomyopathy: Insights From the SHARE Registry.",
    "xml": "<Element 'PubmedArticle' at 0x7885066ea890>"
}