[Asymmetric septal hypertrophy in patients with arterial hypertension]

Asymmetric septal hypertrophy (ASH) is the characteristic finding in patients with hypertrophic cardiomyopathy. The purpose of the present study was to examine the effect of chronic pressure overload on left ventricular hypertrophy and ASH in 34 patients with arterial hypertension. 15 patients (Group 1) showed normal blood pressure values (less than 140/90 mm Hg) under antihypertensive treatment but blood pressure remained elevated in 19 patients (Group 2) despite antihypertensive therapy. Left ventricular septal and posterior wall thickness, left ventricular internal diameter and systolic shortening of the internal diameter were measured in all patients by our standard technique. Systolic and diastolic blood pressure were significantly (p less than 0.001) elevated in Group 2 (164/98 mm Hg) as compared to Group 1 (128/84 mm Hg). Septal (1.7 versus 1.1 cm; p less than 0.01) and posterior wall thickness (1.2 versus 1.0 cm; p less than 0.01) as well as the septal/posterior wall ratio (1.4 versus 1.1; p less than 0.001) were significantly increased in Group 2 as compared to Group 1. Left ventricular internal diameter and systolic shortening of the internal diameter did not significantly differ between the two groups. ASH (septal/posterior wall ration greater than or equal to 1.3) was found in 10 patients of Group 2 (55%) and 1 patient of Group 1 (7%). It is concluded that asymmetric septal hypertrophy can be observed in one third of all patients with severe arterial hypertension. Asymmetric septal hypertrophy seems to be dependent on the duration and severity of hypertension and does not appear to be related to hypertrophic cardiomyopathy.