ArticleArquivos brasileiros de cardiologia2025
Brazilian Multicenter Registry of Alcohol Septal Ablation for Patients with Symptomatic Hypertrophic Obstructive Cardiomyopathy - BRASA Registry.
Article in Arquivos brasileiros de cardiologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Forward Dynamics: Modern Insights into Mitral Systolic Anterior Motion.Journal of cardiovascular development and disease · 2026Review
- Alcohol Septal Ablation in Brazil: Insights from the BRASA Registry.Arquivos brasileiros de cardiologia · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlcohol septal ablation (ASA) is an alternative to surgical myectomy for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) and significant left ventricular (LV) outflow tract (LVOT) obstruction. Although widely studied worldwide, data on ASA outcomes in Brazil are still limited.
objectiveTo assess the safety and effectiveness of ASA in symptomatic HOCM patients receiving optimal medical therapy using current techniques across multiple centers in Brazil.
methodsPatients with HOCM and angina (classified by the Canadian Cardiovascular Society [CCS]) or dyspnea (classified by the New York Heart Association [NYHA]) class >II who did not respond to optimal medical treatment were included. The primary efficacy endpoint was defined as a reduction of more than 50% in the maximum resting LVOT gradient, with a final gradient <50 mmHg. Patients were classified as responders or nonresponders. A p-value <0.05 was considered statistically significant.
resultsA total of 41 patients (median age 66.4 years; 73% female) underwent ASA. At baseline, 93.2% were in NYHA class III/IV or CCS class III/IV. The mean LV ejection fraction (LVEF) was 66.4%, and the mean LVOT gradient was 88.4 mmHg. After 12 months, 92.8% had improved to NYHA class I/II or CCS class I/II (p<0.01). The mean LVOT gradient dropped from 88.4 mmHg to 27.0 mmHg (p=0.003), and interventricular septum (IVS) thickness decreased from 19.3 mm to 14.7 mm (p=0.048). Responders had lower baseline gradients (73.4 vs 112.6 mmHg, p=0.04) and fewer hospitalizations (21.1% vs 82.4%, p=0.04). Complete atrioventricular block occurred in 16.7% of patients, and 4.8% required pacemakers. No deaths were reported during a median follow-up of 394 days. At the last in-person evaluation, 78.4% were in functional class I/II.
conclusionsASA is a safe, effective option for relieving symptoms in selected HOCM patients. It reduces LVOT gradient and septal thickness. Patients with higher baseline gradients were less likely to respond to the procedure.
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