An echocardiographic septal bulge strongly predicted clinical arterial hypertension confirmed by cycle ergometer test or ambulatory blood pressure monitoring (sensitivity 93%, specificity 86%).
Cross-Sectional (n=110)
Does an echocardiographic septal bulge predict subclinical arterial hypertension in patients without known hypertension?
An echocardiographic septal bulge is a strong morphological sign of early, subclinical hypertensive heart disease that should prompt comprehensive blood pressure evaluation.
Effect estimate: Sensitivity 93%, Specificity 86%
Absolute Event Rate: 79.2% vs 4.8%
Patients in the early stage of hypertensive heart disease tend to have normal echocardiographic findings. The aim of this study was to investigate whether pathology-specific echocardiographic morphologic and functional parameters can help to detect subclinical hypertensive heart disease. One hundred ten consecutive patients without a history and medication for arterial hypertension (AH) or other cardiac diseases were enrolled. Standard echocardiography and two-dimensional speckle-tracking-imaging analysis were performed. Resting blood pressure (BP) measurement, cycle ergometer test (CET), and 24-hour ambulatory BP monitoring (ABPM) were conducted. Patients were referred to "septal bulge (SB)" group (basal-septal wall thickness ≥ 2 mm thicker than mid-septal wall thickness) or "no-SB" group. Echocardiographic SB was found in 48 (43.6%) of 110 patients. In this SB group, 38 (79.2%) patients showed AH either by CET or ABPM. In contrast, in the no-SB group (n = 62), 59 (95.2%) patients had no positive test for AH by CET or ABPM. When AH was solely defined by resting BP, SB was a reasonable predictive sign for AH (sensitivity 73%, specificity 76%). However, when AH was confirmed by CET or ABPM the echocardiographic SB strongly predicted clinical AH (sensitivity 93%, specificity 86%). In addition, regional myocardial deformation of the basal-septum in SB group was significantly lower than in no-SB group (14 ± 4% vs. 17 ± 4%; P < .001). In conclusion, SB is a morphologic echocardiographic sign for early hypertensive heart disease. Sophisticated BP evaluation including resting BP, ABPM, and CET should be performed in all patients with an accidental finding of a SB in echocardiography.
Gaudron et al. (Wed,) conducted a cross-sectional in Hypertensive heart disease (n=110). Echocardiographic septal bulge vs. No septal bulge was evaluated on Arterial hypertension confirmed by cycle ergometer test or 24-hour ambulatory BP monitoring (Sensitivity 93%, Specificity 86%). An echocardiographic septal bulge strongly predicted clinical arterial hypertension confirmed by cycle ergometer test or ambulatory blood pressure monitoring (sensitivity 93%, specificity 86%).
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