Localized Basal Ventricular Septal Hypertrophy: Prevalence, Functional and Clinical Correlates in a Population Referred for Echocardiography

Abstract

Localized hypertrophy of the basal ventricular septum was detected in 27 (0.7%) of 4,000 patients, referred for echocardiography for clinical indications, who were studied prospectively. This finding was seen primarily in older patients (mean age 66 years) without resting left ventricular outflow gradients or a family history of hypertrophic cardiomyopathy or sudden death. Although patients presented with a variety of symptoms, these were not clearly related to the septal hypertrophy.

Basal Septal Hypertrophy

“…A history of hypertension was evident in 6 of the 7 subjects, whilst it was present in only 2 of the 8 patients in the Shapiro et al study. Using different definitions, later authors reported prevalence rates as high as 10% for isolated BSH [ 4 , 5 ]. Whilst the variability in prevalence likely reflects the variability in definitions used for BSH, differences in the burden of comorbid hypertension might also have contributed.…”

2020 Clinical practice guidelines for Hypertrophic cardiomyopathy

“…• Всем пациентам с ГКМП измерение максимальной диастолической толщины миокарда ЛЖ рекомендуется проводить во всех сегментах, от базальных до верхушки в 2D-режиме по короткой оси ЛЖ [94,149,191,193,[202][203][204].…”

The evolution of basal septal hypertrophy: From benign and age‐related normal variant to potentially obstructive and symptomatic cardiomyopathy

“…In 1992, Gardin et al . reported the finding of 27 cases of what they termed as “lower basal ventricular septal hypertrophy” (LBVSH) out of 4000 patients referred for TTE.…”

“…In 1992, Gardin et al 13 reported the finding of 27 cases of what they termed as "lower basal ventricular septal hypertrophy" (LBVSH) out of 4000 patients referred for TTE. Interestingly, they excluded patients for an apparent increase in BST "due to an abnormally increased angle between the septum and aortic root."…”

“…Localized thickening of the basal portion of the ventricular septum has been identified by necropsy and imaging studies for decades, but there is no consensus on its significance and a remarkable lack of consistency in terminology. This anatomic finding has been termed localized hypertrophy of the upper portion of the ventricular septum, 1 disproportionate ventricular septal hypertrophy, 2 disproportionate upper septal thickening, 2-4 sigmoid or sigmoid-shaped (interventricular) septum, 5-10 localized septal hypertrophy, 11,12 basal ventricular septal hypertrophy, 13 ventricular septal bulge, 14,15 discrete upper septal thickening, 16 upper septal knuckle/discrete upper septal thickening, 17 basal septal hypertrophy, 18,19 sigmoid (sic) hypertrophy of the ventricular septum, characterized by the knob-like prominence of its basal subaortic segment, 20 isolated hypertrophy of the basal septum, 21 isolated basal septal hypertrophy (sigmoid septum) in elderly people, 22 and ventricular septal bulge. 6,15 Early studies suggested that basal septal hypertrophy (BSH) was a nonpathologic result of aging or of uncoiling of the aorta and it has been related to the aortic/septal angle, aging, aortic stenosis, and hypertension.…”