{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:10:39Z","timestamp":1791360639117,"version":"4.3.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,10,22]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Septal reduction therapy (SRT) provides substantial symptomatic improvement in patients with obstructive hypertrophic cardiomyopathy (HCM). However, long-term disease course after SRT and predictors of adverse outcomes have not been systematically examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Data from 13 high clinical volume HCM centers from the international SHARE (Sarcomeric Human Cardiomyopathy Registry) were analyzed. Patients were followed from the time of SRT until last follow-up or occurrence of heart failure (HF) composite outcome (cardiac transplantation, implantation of a left ventricular assist device, left ventricular ejection fraction &lt;35%, development of New York Heart Association class III or IV symptoms), ventricular arrhythmias composite outcome (sudden cardiac death, resuscitated cardiac arrest, or appropriate implantable cardioverter defibrillator therapy), or HCM-related death. Cox proportional hazards models were used to identify predictors of outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of the 10 225 patients in SHARE, 1832 (18%; 968 [53%] male) underwent SRT, including 455 (25%) with alcohol septal ablation and 1377 (75%) with septal myectomy. The periprocedural 30-day mortality rate was 0.4% (8 of 1832) and 1499 of 1565 (92%) had a maximal left ventricular outflow tract gradient &lt;50 mm Hg at 1 year. After 6.8 years (range, 3.4\u20139.8 years; 12 565 person-years) from SRT, 77 (4%) experienced HCM-related death (0.6% per year), 236 (13%) a composite HF outcome (1.9% per year), and 87 (5%) a composite ventricular arrhythmia outcome (0.7% per year). Among adults, older age at SRT was associated with a higher incidence of HCM death (hazard ratio, 1.22 [95 CI, 1.1\u20131.3];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01) and the HF composite (hazard ratio, 1.14 [95 CI, 1.1\u20131.2] per 5-year increase;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01) in a multivariable model. Female patients also had a higher risk of the HF composite after SRT (hazard ratio, 1.4 [95 CI, 1.1\u20131.8];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). De novo atrial fibrillation occurred after SRT in 387 patients (21%). Among pediatric patients followed for a median of 13 years after SRT, 26 of 343 (16%) developed the HF composite outcome, despite 96% being free of recurrent left ventricular outflow tract obstruction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Successful short- and long-term relief of outflow tract obstruction was observed in experienced multidisciplinary HCM centers. A subset of patients progressed to develop HF, but event-free survival at 10 years was 83% and ventricular arrhythmias were rare. Older age, female sex, and SRT during childhood were associated with a greater risk of developing HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.124.069378","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T05:00:59Z","timestamp":1727845259000},"page":"1377-1390","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Long-Term Outcomes After Septal Reduction Therapies in Obstructive Hypertrophic Cardiomyopathy: Insights From the SHARE Registry"],"prefix":"10.1161","volume":"150","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-204X","authenticated-orcid":true,"given":"Niccol\u00f2","family":"Maurizi","sequence":"first","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy (N.M., C.F., I.O.)."},{"name":"Service of Cardiology, University Hospital of Lausanne, Switzerland (N.M., P.A., I.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8466-7360","authenticated-orcid":true,"given":"Panagiotis","family":"Antiochos","sequence":"additional","affiliation":[{"name":"Service of Cardiology, University Hospital of Lausanne, Switzerland (N.M., P.A., I.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9669-8495","authenticated-orcid":true,"given":"Anjali","family":"Owens","sequence":"additional","affiliation":[{"name":"Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., S.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6458-5421","authenticated-orcid":true,"given":"Neal","family":"Lakdawala","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Boston, MA (N.L., C.Y.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-6725","authenticated-orcid":true,"given":"Sara","family":"Saberi","sequence":"additional","affiliation":[{"name":"Departments of Internal Medicine (S.S., A.S.H.), University of Michigan, Ann Arbor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"Russell","sequence":"additional","affiliation":[{"name":"Pediatrics (M.W.R.), University of Michigan, Ann Arbor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7963-5049","authenticated-orcid":true,"given":"Carlo","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy (N.M., C.F., I.O.)."},{"name":"Department of Advanced and Surgical Sciences, University of Campania-Luigi Vanvitelli, Naples, Italy (C.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Skalidis","sequence":"additional","affiliation":[{"name":"Service of Cardiology, University Hospital of Lausanne, Switzerland (N.M., P.A., I.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-9797","authenticated-orcid":true,"given":"Kimberly Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Philadelphia, PA (K.Y.L., R.L., J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-6423","authenticated-orcid":true,"given":"Ashwin S.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Penn Center for Inherited Cardiovascular Disease, Hospital of the University of Pennsylvania and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia (A.O., A.S.N., A.D.F.A., N.R., 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