hypertrophic obstructive cardiomyopathy

ABC

Editorial

Alcohol Septal Ablation in Brazil: Insights from the BRASA Registry

Maria Antonieta Albanez A. de Medeiros Lopes et al. Mayara Viana Júlia Nóbrega Heitor N. Albanez A. de Medeiros Gláucia Maria Moraes de Oliveira

The Brazilian Multicenter Registry of Alcohol Septal Ablation (BRASA Registry), published in ABC Cardiol in 2025, represents a pivotal contribution to understanding the safety, efficacy, and real-world applicability of Alcohol Septal Ablation (ASA) in Brazil—a country marked by healthcare disparities and a high burden of cardiovascular diseases. This registry provides unprecedented data on ASA outcomes in Brazilian centers, reinforcing its role as a viable alternative to surgical myectomy in hypertrophic obstructive cardiomyopathy (HOCM).

Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac disorder, historically associated with high morbidity and mortality. However, advances in diagnostic imaging, pharmacological therapies, and interventional techniques have transformed HCM into a treatable condition, with many patients now achieving near-normal life expectancy. Over the past two decades, mortality rates have declined dramatically—from 6% to 0.5% per year—largely due to early risk stratification, implantable cardioverter-defibrillators, and septal reduction therapies.

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Original Article

Percutaneous transluminal septal alcoholization for the treatment of refractory hypertrophic obstructive cardiomyopathy: initial experience in the Federal District

Evandro César Vidal Osterne et al. Tamer Najar Seixas Walter Paulo Filho Ernesto Misael Cintra Osterne Otoni Moreira Gomes

OBJECTIVE: To analyze the efficacy of percutaneous transluminal septal alcoholization in the treatment of refractory obstructive hypertrophic cardiomyopathy (HOC). METHODS: The patients were referred for alcoholization after Doppler echocardiography. Before and after alcoholization, the intraventricular pressure gradient was recorded. Alcoholization was performed with a 3mL injection of absolute alcohol through a coronary angioplasty balloon catheter. The procedure was concluded after a significant reduction or abolition of the pressure gradient. RESULTS: Of 22 patients, 18 (81.8%) successfully concluded the procedure with a reduction in intraventricular pressure gradient at baseline (from 67.6±24.2 mmHg to 3.8± 1.9 mmHg, p<0.005) and after extrasystole (from 110.4± 24.2 mmHg to 9.6±2.6 mm Hg, p<0.005). A significant reduction in mean interventricular septal thickness (from 2± 0.3 mm to 1.7±0.2 mm, p<0.005) and in peak pressure gradient (from 90.7±23.5 mmHg to 6.1±1.4 mmHg, p<0.005) was observed on Doppler echocardiography after 6 months, when all patients were in functional class I. The most frequent acute complication, present in 11% of the patients, was the need for definitive pacing implantation. Relapse of the symptoms and reappearance of the pressure gradient occurred in 16.6% of the patients. One patient (5.5%) died probably due to a diffuse coronary spasm prior to the procedure, and another died suddenly on late follow-up. CONCLUSION: Percutaneous transluminal septal alcoholization is effective and safe in the treatment of HOC.

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Alcohol Septal Ablation in Brazil: Insights from the BRASA Registry

Percutaneous transluminal septal alcoholization for the treatment of refractory hypertrophic obstructive cardiomyopathy: initial experience in the Federal District

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Electronic Document Format (ABNT)

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Electronic Document Format (ISO)