Isolated hypertrophy of the basal ventricular septum: Characteristics of patients with and without outflow tract obstruction

Distinguishing ventricular septal bulge versus hypertrophic cardiomyopathy in the elderly

“…Patients with VSB did not display a sex preference,1 14 15 in contrast to HCM, which has been generally characterised by a 3:2 male predominance,6 at least at younger ages 20 21. A recent review of 969 consecutive American and Italian patients with HCM demonstrated a reversed 60% versus 30% female predominance only in patients older than 60 years of age 22.…”

“…They accounted for about 30% in a series of 277 patients with HCM,6 though this is probably an underestimate of the true prevalence 7 8 18 19. On the contrary, it is widely recognised that the prevalence of VSB increases with age,1 14 15 ranging from 4% to 8% in individuals ≥60 years of age and reaching 10% in the eighth decade of life 1 14 15. Thus, VSB seems to be diagnosed more frequently than HCM at older ages.…”

“…Studies generally include individuals with an isolated basal septal hypertrophy and a wall thickness >12–13 mm; sometimes a proximal-to-mid/distal septal wall thickness ratio ≥1.3–1.5 is used as an additional criterion, and the presence of left ventricular outflow tract obstruction as an exclusion criterion, because considered diagnostic for HCM. The phenotype has been variously labelled ventricular septal bulge (VSB),1–3 sigmoid-shaped septum,12 localised4 5 13 or isolated14 or discrete upper or basal septal hypertrophy 15 16. Detailed definitions of VSB in each study are presented in online supplementary table S1.…”

The evaluation of left ventricular dyssynchronization in patients with hypertension by phase analysis of myocardial perfusion-gated SPECT

“…Left ventricular dyssynchrony (LVD) is commonly observed in patients with hypertension and it is associated with LVH [4,5]. Usually LVH is an asymmetrical hypertrophy, involving the interventricular septum and it is known as asymmetrical septal hypertrophy (ASH) [6,7]. Therefore, ASH can be considered as a type of LVH and it is quite common finding to be found in patients with hypertension.…”

Intra-ventricular rebound flow and systolic anterior motion of the mitral valve with left ventricular outflow tract obstruction in elderly, hypertensive women

“…Velocity-encoded cine, phase-contrast MRI revealed rebound flow from the LV base to the apex during mid to late systole, suggesting a rebound flow due to SAM-related obstruction in the LVOT (Figs. 2 and 3).SAM involves a complex mechanism and is a cause of LVOT obstruction [1][2][3][4][5][6][7][8]. To our knowledge, this is the first case to confirm rebound flow during SAM using phase contrast MRI.…”