{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:32:45Z","timestamp":1772253165109,"version":"3.50.1"},"reference-count":24,"publisher":"Sociedade Brasileira de Cardiologia","issue":"6","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A abla\u00e7\u00e3o septal alco\u00f3lica (ASA) \u00e9 uma alternativa \u00e0 miectomia cir\u00fargica para pacientes com cardiomiopatia hipertr\u00f3fica obstrutiva (CMHO) sintom\u00e1tica e obstru\u00e7\u00e3o significativa da via de sa\u00edda do ventr\u00edculo esquerdo (VSVE). Embora amplamente estudada em outros pa\u00edses, ainda h\u00e1 poucos dados sobre os resultados da ASA no Brasil.  Objetivo  Avaliar a seguran\u00e7a e a efic\u00e1cia da ASA em pacientes sintom\u00e1ticos com CMHO, tratados com terapia medicamentosa otimizada, utilizando t\u00e9cnicas atuais em diferentes centros brasileiros.  M\u00e9todos  Foram inclu\u00eddos pacientes com CMHO e angina (classifica\u00e7\u00e3o da Canadian Cardiovascular Society [CCS]) ou dispneia (classifica\u00e7\u00e3o da New York Heart Association [NYHA]) em classe funcional acima de II, sem resposta ao tratamento medicamentoso otimizado. O desfecho prim\u00e1rio de efic\u00e1cia foi definido como a redu\u00e7\u00e3o superior a 50% no gradiente m\u00e1ximo da VSVE em repouso, com valor final &lt;50 mmHg. Os pacientes foram classificados como responsivos ou n\u00e3o responsivos. Um valor de p&lt;0.05 foi considerado estatisticamente significativo.  Resultados  Um total de 41 pacientes (idade mediana de 66,4 anos; 73% mulheres) foi submetido \u00e0 ASA. No in\u00edcio, 93,2% estavam em classe funcional III\/IV da NYHA ou CCS. A fra\u00e7\u00e3o de eje\u00e7\u00e3o do ventr\u00edculo esquerdo (FEVE) m\u00e9dia era de 66,4%, e o gradiente m\u00e9dio da VSVE era de 88,4 mmHg. Ap\u00f3s 12 meses, 92,8% apresentaram melhora para classe funcional I\/II da NYHA ou CCS (p&lt;0,01). O gradiente m\u00e9dio da VSVE caiu de 88,4 mmHg para 27,0 mmHg (p=0,003), e a espessura do septo interventricular (SIV) diminuiu de 19,3 mm para 14,7 mm (p=0,048). Pacientes responsivos apresentaram gradientes basais menores (73,4 vs 112,6 mmHg, p=0,04) e menos hospitaliza\u00e7\u00f5es (21,1% vs 82,4%, p=0,04). Bloqueio atrioventricular completo ocorreu em 16,7% dos casos, e 4,8% necessitaram de marcapasso. N\u00e3o houve \u00f3bitos durante o seguimento mediano de 394 dias. Na \u00faltima avalia\u00e7\u00e3o presencial, 78,4% estavam em classe funcional I\/II.  Conclus\u00f5es  A ASA \u00e9 uma op\u00e7\u00e3o segura e eficaz para al\u00edvio dos sintomas em pacientes selecionados com CMHO. O procedimento reduz o gradiente da VSVE e a espessura septal. Pacientes com gradientes basais mais elevados apresentaram menor taxa de resposta.<\/jats:p>","DOI":"10.36660\/abc.20240626","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T14:20:21Z","timestamp":1751293221000},"source":"Crossref","is-referenced-by-count":1,"title":["Registro Multic\u00eantrico Brasileiro de Abla\u00e7\u00e3o Septal Alco\u00f3lica em Pacientes com Miocardiopatia Hipertr\u00f3fica Obstrutiva Sintom\u00e1tica \u2013 Registro BRASA"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6997-3865","authenticated-orcid":false,"given":"Pedro","family":"Jallad","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilia","family":"Soliani","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Henrique Almeida","family":"Marins","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9323-8805","authenticated-orcid":false,"given":"F\u00e1bio","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmundo","family":"Arteaga-Fernandez","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vagner","family":"Madrini","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Lemos Neto","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8838-199X","authenticated-orcid":false,"given":"Charles","family":"Mady","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2437-2485","authenticated-orcid":false,"given":"Felix","family":"Ramires","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre A.","family":"Abizaid","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-9626","authenticated-orcid":false,"given":"F\u00e1bio S\u00e2ndoli de","family":"Brito Jr","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil; Hospital S\u00edrio-Liban\u00eas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1273-1823","authenticated-orcid":false,"given":"Henrique Barbosa","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"4","key":"ref1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.jacc.2021.11.021","article-title":"Management of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review","volume":"79","author":"Maron BJ","year":"2022","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"ref2","doi-asserted-by":"crossref","DOI":"10.36660\/abc.20240415i","article-title":"Guidelines on the Diagnosis and Treatment of Hypertrophic Cardiomyopathy - 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