Patterns of isolated septal hypertrophy and their clinical correlations in essential hypertension

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 + I 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.