Average septal curvature demonstrated better reproducibility than conventional wall thickness ratios, with interobserver variability of 8% versus 38%, and correlated more strongly with functional remodeling.
Cross-Sectional (n=220)
Does average septal curvature provide a more reproducible and functionally correlated marker for basal septal hypertrophy compared to conventional wall thickness metrics in hypertensive patients?
Average septal curvature is a highly reproducible, automatable imaging metric that outperforms conventional wall thickness ratios for characterizing basal septal hypertrophy and its functional impact in hypertensive patients.
Tasa de eventos absoluta: 8% vs 38%
BACKGROUND: Basal septal hypertrophy (BSH) is an asymmetric, localized thickening of the upper interventricular septum and constitutes a marker of an early remodelling in patients with hypertension. This morphological trait has been extensively researched because of its prevalence in hypertension, yet its clinical and prognostic value for individual patients remains undetermined. One of the reasons is the lack of a reliable and reproducible metric to quantify the presence and the extent of BSH. This article proposes the use of the curvature of the left ventricular endocardium as a robust feature for BSH characterization, and as an objective criterion to quantify current subjective 'visual assessment' of the presence of sigmoidal septum. The proposed marker, called average septal curvature, is defined as the inverse of the radius adjacent to each point of the endocardial contour along the basal and mid inferoseptal segments of the left ventricle. METHOD: Robustness and reproducibility were assessed on a cohort of 220 patients, including 161 hypertensive patients (32 with BSH) and 59 healthy controls. RESULTS: The results show that compared with the conventionally used wall thickness metrics, the new marker is more reproducible (relative standard deviation of errors of 7 vs. 13%, and 8 vs. 38% for intra-observer and inter-observer variability, respectively) and better correlates to the functional parameters related to BSH, with main difference (absolute rank correlation 0.417 vs. 0.341) in local deformation changes assessed by longitudinal strain. CONCLUSION: Average septal curvature is a more precisely defined and reproducible metric than thickness ratios, it can be fully automated, and better infers the functional remodelling related to hypertension.
Marciniak et al. (Sat,) conducted a cross-sectional in Basal septal hypertrophy in hypertension (n=220). Average septal curvature vs. Wall thickness ratio was evaluated on Interobserver variability (relative standard deviation of errors). Average septal curvature demonstrated better reproducibility than conventional wall thickness ratios, with interobserver variability of 8% versus 38%, and correlated more strongly with functional remodeling.