Abstract
The morphological patterns and their clinical correlations in 96 essential hypertensive patients (pts) with isolated septal hypertrophy (IVSH) were studied by 2-dimensional echocardiography. Three patterns of IVSH: basal (B), diffuse (D), and midportion (M) types, were identified by parasternal long-axis image, and four patterns of hypertrophy in the left ventricular (LV) wall: diffuse except posterior wall (type I), anterolateral wall and anterior septum (type II), whole septum (type III), and anterior septum (type IV), were recognized by parasternal short-axis image. A total of 12 different types of LV hypertrophy could be classified. B + I, B + IV, and D + I types were each present in more than 10 pts. The B + IV type had the oldest mean age of 72 years (vs B + I: 63,p <0.05 and D + I: 64,p = 0.1), D + 1 vs B + I,p = 0.5. The D + I type had the highest mean diastolic blood pressure, 108 mmHg (vs B + I: 103,p <0.05, and B + IV: 96,p <0.001), B + I vs B + IV,p <0.01. The B + I type had the longest duration of hypertension, 24 years (vs B + IV: 15,p <0.001 and D + I: 21,p = 0.1), B + IV vs D + I,p <0.05. Seven pts (70%) of M + I type had a family history of cardiomyopathy and/or apical hypertrophy. We conclude that arterial hypertension is associated with a spectrum of isolated septal hypertrophy correlating with clinical characteristics.
