Journal of cardiothoracic surgery · 2025
Surgical myectomy might inhibit ascending aortic dilation in obstructive hypertrophic cardiomyopathy: a serial cardiac magnetic resonance study.
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Song Changpeng, Guo Xinli, Zheng Xinxin, Lu Jie, Cui Jingang, Wang Shuiyun, Huang Xiaohong
Аннотация
BACKGROUND: The impact of septal myectomy on the progression of ascending aortic (AAo) dilation in patients with obstructive hypertrophic cardiomyopathy (HOCM) remains uncertain. This study aimed to investigate the relationship between septal myectomy and AAo dilation in HOCM patients.
METHODS: A total of 69 patients with HOCM were enrolled. All the participants underwent sequential cardiac magnetic resonance scans at a mean interval of 5.13 ± 2.04 years, with each scan being more than 3 years apart.
RESULTS: At baseline, 17 patients with HOCM (25%) exhibited AAo dilation (Indexed AAo dimension > 19 mm/m²). Age (OR 1.10, 95%CI: 1.01-1.019, P = 0.026) and female (OR 4.80, 95%CI: 1.05-21.93, P = 0.043) were independently associated with AAo dilation. In patients who underwent myectomy, the AAo dimension at follow-up was similar to that at baseline (32.47 ± 4.70 mm vs. 32.81 ± 5.06 mm, P = 0.197). Furthermore, the rate of AAo dilation was lower in patients with myectomy compared to those without myectomy (-0.06 ± 0.38 mm/year vs. 0.18 ± 0.43 mm/year, P = 0.016). Additionally, moderate or severe mitral regurgitation was significantly associated with AAo dilation rate (B = 0.273, P = 0.032).
CONCLUSIONS: Myectomy in patients with HOCM was associated with the absence of progression of AAo dilatation.
METHODS: A total of 69 patients with HOCM were enrolled. All the participants underwent sequential cardiac magnetic resonance scans at a mean interval of 5.13 ± 2.04 years, with each scan being more than 3 years apart.
RESULTS: At baseline, 17 patients with HOCM (25%) exhibited AAo dilation (Indexed AAo dimension > 19 mm/m²). Age (OR 1.10, 95%CI: 1.01-1.019, P = 0.026) and female (OR 4.80, 95%CI: 1.05-21.93, P = 0.043) were independently associated with AAo dilation. In patients who underwent myectomy, the AAo dimension at follow-up was similar to that at baseline (32.47 ± 4.70 mm vs. 32.81 ± 5.06 mm, P = 0.197). Furthermore, the rate of AAo dilation was lower in patients with myectomy compared to those without myectomy (-0.06 ± 0.38 mm/year vs. 0.18 ± 0.43 mm/year, P = 0.016). Additionally, moderate or severe mitral regurgitation was significantly associated with AAo dilation rate (B = 0.273, P = 0.032).
CONCLUSIONS: Myectomy in patients with HOCM was associated with the absence of progression of AAo dilatation.