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In addition, the impact of percutaneous transluminal septal myocardial ablation (PTSMA) on CMD has not been fully evaluated. Between October 2023 and May 2024, PTSMA was performed on 10 patients with oHCM. A pressure guidewire in the left anterior descending artery (LAD) was used to invasively assess CMD before and after the procedure. Measurements were recorded for resting full-cycle ratio (RFR), fractional flow reserve (FFR), coronary flow reserve (CFR), and index of microcirculatory resistance (IMR). The 10 patients had a median age of 66 [57\u201375] years, with a resting left ventricular pressure gradient of 44 [17\u201384] mmHg, measured via catheterization. Prior to PTSMA, the RFR measured in the LAD was 0.93 [0.91\u20130.96], and the FFR was 0.95 [0.92\u20130.95], which were both within normal limits. However, the CFR was reduced to 1.8 [1.6\u20132.1], and the IMR was elevated to 31 [25\u201339], which indicated CMD. Post-procedure, the left ventricular pressure gradient decreased to 5 [2\u20138] mmHg, CFR improved to 2.5 [2.2\u20133.6], and IMR decreased to 22 [17\u201326], indicating improvement in CMD. In patients with oHCM, myocardial hypertrophy contributes to left ventricular outflow tract obstruction and CMD. This study demonstrated that PTSMA as a septal reduction therapy improved the left ventricular pressure gradient and CMD.<\/jats:p>\n          <jats:p>\n            <jats:bold>Graphical abstract<\/jats:bold>\n          <\/jats:p>","DOI":"10.1007\/s12928-025-01154-1","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:21:29Z","timestamp":1750983689000},"page":"973-981","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A pilot study on coronary microvascular dysfunction in obstructive hypertrophic cardiomyopathy: impact of percutaneous transluminal septal myocardial ablation"],"prefix":"10.1007","volume":"40","author":[{"given":"Taikan","family":"Terauchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2758-1135","authenticated-orcid":false,"given":"Daigo","family":"Hiraya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyohei","family":"Usami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Yaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Watabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Hoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Ishizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"1154_CR1","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1016\/j.jcin.2015.06.017","volume":"8","author":"JD Sara","year":"2015","unstructured":"Sara JD, Widmer RJ, Matsuzawa Y, Lennon RJ, Lerman LO, Lerman A. 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Therefore, consent for publication is not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}