{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:50:08Z","timestamp":1792183808098,"version":"4.4.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic cardiac disease characterized by left ventricular hypertrophy that induces left ventricular outflow tract obstruction (LVOTO), which occurs in \u223c25% of patients with hypertrophic cardiomyopathy (HCM), and, less commonly, a midventricular obstruction (MVO). Percutaneous transluminal septal myocardial ablation (PTSMA) treatment for HOCM has become an established therapy to alleviate LVOTO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 78-year-old woman with HOCM and severe MVO underwent PTSMA using simultaneous contrast imaging with left ventriculography (LVG) and coronary angiography (CAG). After the procedure, the pressure gradient between the aorta and left ventricular apex improved from 140 to 35\u2005mmHg at rest and from 195 to 40\u2005mmHg at post-extra-systolic potentiation. The residual pressure gradient in the left ventricular mid-ventricle and left ventricular outflow tract was 15 and 10\u2005mmHg, respectively. Her clinical condition improved significantly, and she remained well without any symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Midventricular obstruction is relatively rare, occurring in \u223c5%\u201310% of patients with hypertrophic cardiomyopathy; therefore, it is substantially underdiagnosed or missed, leading to suboptimal treatment in a high proportion of patients. Thus, physicians should consider the possibility of MVO when evaluating patients with HCM to avoid overlooking it. Confirmation and clarification of the detailed anatomical relationship between MVO\/LVOTO and effective septal branches using contrast imaging with LVG, CAG, and occlusion tests might be essential for achieving effective clinical outcomes in patients with HOCM concomitant with MVO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag659","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:38:36Z","timestamp":1788161916000},"source":"Crossref","is-referenced-by-count":0,"title":["Hypertrophic obstructive cardiomyopathy complicated by severe midventricular obstruction treated with percutaneous transluminal septal myocardial ablation using simultaneous contrast imaging with left ventriculography and coronary angiography: a case report"],"prefix":"10.1093","volume":"10","author":[{"given":"Togo","family":"Sakai","sequence":"first","affiliation":[{"name":"Cardiovascular Centre, Social Medical Corporation, Steel Memorial Yawata Hospital , Haruno-machi, Yahatahigashi-ku, Kitakyushu 805-8508 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6047-9653","authenticated-orcid":false,"given":"Masao","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Cardiovascular Centre, Social Medical Corporation, Steel Memorial Yawata Hospital , Haruno-machi, Yahatahigashi-ku, Kitakyushu 805-8508 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Numaguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kitakyushu Municipal Medical Center , Kitakyushu 802-8561 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-1117","authenticated-orcid":false,"given":"Takuya","family":"Tsuchihashi","sequence":"additional","affiliation":[{"name":"Cardiovascular Centre, Social Medical Corporation, Steel Memorial Yawata Hospital , Haruno-machi, Yahatahigashi-ku, Kitakyushu 805-8508 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"2026101616270308500_ytag659-B1","doi-asserted-by":"crossref","first-page":"2346","DOI":"10.1016\/j.jacc.2011.02.033","article-title":"Clinical implications of midventricular obstruction in patients with hypertrophic cardiomyopathy","volume":"57","author":"Minami","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026101616270308500_ytag659-B2","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2025.101728","article-title":"Investigating the Anrep effect in hypertrophic obstructive cardiomyopathy with invasive pressure-volume analysis","volume":"4","author":"Reil","year":"2025","journal-title":"JACC Adv"},{"key":"2026101616270308500_ytag659-B3","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1016\/j.jacc.2018.09.064","article-title":"Survival after alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy","volume":"72","author":"Batzner","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2026101616270308500_ytag659-B4","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1016\/j.jacc.2011.06.073","article-title":"Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. 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