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Basal septal hypertrophy.

Mihir A Kelshiker, Jamil Mayet, Beth Unsworth

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Summary

This review examines basal septal hypertrophy (BSH) and its link to heart failure with normal ejection fraction (HFNEF). It explores how BSH may cause breathlessness in patients without other identifiable cardiac or lung issues.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Patients with unexplained exercise-limiting dyspnea often present with normal left ventricular systolic function.
  • Isolated basal septal hypertrophy (BSH) is frequently observed in these patients, particularly older females with mild hypertension.
  • This clinical presentation overlaps with the controversial diagnosis of heart failure with normal ejection fraction (HFNEF).

Purpose of the Study:

  • To review the existing literature on basal septal hypertrophy (BSH).
  • To identify potential associations between BSH and heart failure with normal ejection fraction (HFNEF).
  • To explore the pathophysiological mechanisms linking BSH to HFNEF symptoms.

Main Methods:

  • Literature review and analysis of studies on basal septal hypertrophy.
  • Examination of clinical data and diagnostic criteria for heart failure with normal ejection fraction.
  • Synthesis of pathophysiological hypotheses regarding BSH and dyspnea.

Main Results:

  • Basal septal hypertrophy is a distinct echocardiographic finding.
  • A significant correlation exists between BSH and symptoms of heart failure with normal ejection fraction.
  • Potential mechanisms include diastolic dysfunction and impaired ventricular-arterial coupling.

Conclusions:

  • Basal septal hypertrophy may be a key contributor to heart failure with normal ejection fraction symptoms.
  • Further research is needed to elucidate the precise pathophysiological pathways.
  • Understanding this association can improve diagnosis and management of unexplained dyspnea.