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Comparisons of Left Ventricular Hypertrophy due to Essential Hypertension and Hypertrophic Non-Obstructive

Mareomi Hamada1, Sayuri Uga-Yamabe2, Shuntaro Ikeda3

  • 1Division of Cardiology, Uwajima City Hospital.

International Heart Journal
|November 12, 2025
PubMed

Insights

Essential hypertension (EH) and hypertrophic non-obstructive cardiomyopathy (HNCM) both cause left ventricular hypertrophy (LVH). HNCM shows more severe myocardial ischemia and distinct LVH distribution compared to EH.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Clinical Electrophysiology

Background:

  • Left ventricular hypertrophy (LVH) is a hallmark of both essential hypertension (EH) and hypertrophic non-obstructive cardiomyopathy (HNCM).
  • Understanding the differences in LVH severity and distribution between EH and HNCM is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To compare the severity and distribution patterns of left ventricular hypertrophy (LVH) between patients with essential hypertension (EH) and hypertrophic non-obstructive cardiomyopathy (HNCM).
  • To investigate the correlation between electrocardiographic findings and echocardiographic parameters in these conditions.

Main Methods:

  • Included 44 patients with EH and 79 with HNCM, all exhibiting precordial negative T-waves (NTs) without LV heart failure.
  • Electrocardiographic assessments included SV1 + RV5 and maximum NT depth; echocardiography measured routine indices.
  • Analyzed interventricular septal thickness (IVST), LV posterior wall thickness (PWT), and LV mass index.

Main Results:

  • HNCM demonstrated greater SV1 + RV5 and maximum NT depth than EH, with a significantly steeper correlation slope (4.8x) in HNCM, indicating more severe myocardial ischemia.
  • Distinct NT distribution patterns were observed: V6 in EH, and V4/V5 in HNCM.
  • IVST/PWT ratio was significantly higher in HNCM (1.20 ± 0.35) than EH (0.91 ± 0.10); LV mass index was similar between groups.

Conclusions:

  • While LVH severity (mass index) is comparable, myocardial ischemia is more pronounced in HNCM than EH.
  • The distribution pattern of LVH and associated ECG markers differ significantly between EH and HNCM, aiding in differential diagnosis.

Keywords:
EchocardiographyElectrocardiographyMyocardial ischemia

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