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Disproportionate intraventricular septal hypertrophy in Nigerians with essential hypertension
A A Ajayi1, A O Akintomide, R O Babalola
1Department of Medicine, Faculty of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Insights
Essential hypertension may lead to hypertensive hypertrophic cardiomyopathy in some patients, particularly the elderly and males. Echocardiography can help identify these individuals for closer monitoring.
Area of Science:
- Cardiology
- Hypertension Research
Background:
- The coexistence of hypertrophic cardiomyopathy and essential hypertension is not well understood.
- It remains unclear if chronic hypertension can directly cause hypertrophic cardiomyopathy, termed hypertensive hypertrophic cardiomyopathy.
Purpose of the Study:
- To investigate the frequency of hypertrophic cardiomyopathy in Nigerians with essential hypertension.
- To identify characteristics of hypertensive patients who may develop hypertrophic cardiomyopathy.
Main Methods:
- Eighty-three Nigerian patients with essential hypertension underwent M-mode and 2D echocardiography.
- Intraventricular septal hypertrophy was assessed using the septum to posterior wall ratio (>= 1.4).
Main Results:
- Twenty percent (17 patients) exhibited disproportionate intraventricular septal hypertrophy.
- This subgroup was older (average 57.7 years) and predominantly male (70%).
- Two patients showed features consistent with hypertensive hypertrophic cardiomyopathy, including thickened posterior left ventricles and hyperdynamic systolic function.
Conclusions:
- A significant proportion of essential hypertensive patients may develop disproportionate septal hypertrophy.
- Routine echocardiography can aid in early identification of hypertensive patients with specific septal thickening for closer follow-up.
- Further long-term studies are needed to determine the prognostic implications of these findings.
Abstract:
It is not clear how frequently hypertrophic cardiomyopathy coexists with essential hypertension or whether chronic hypertension per se, induces hypertrophic cardiomyopathy (hypertensive hypertrophic cardiomyopathy). Eighty-three Nigerians with essential hypertension alone underwent M-mode and 2 dimensional echocardiographic study. Twenty per cent (17 patients) had disproportionate intraventricular septal hypertrophy (septum: posterior wall ratio > or = 1.4). These subgroup tended to be elderly, with average age of 57.7 years, and were predominantly male (70%). Two patients in this subgroup (2.4% of total) additionally had thickened posterior left ventricles and a hyperdynamic left ventricular systolic function (fractional fibre shortening of > or = 45%). This picture is consistent with "hypertensive hypertrophic cardiomyopathy". Routine echocardiography may permit the early identification and thus a closer scrutiny and follow up of essential hypertensive patients with disproportionate septal thickness. The prognostic implications of this requires long term study.