Left Ventricular Hypertrophy Diagnosed by Echocardiography

Echocardiography was used to differentiate left ventricular hypertrophy due to hypertrophic cardiomyopathy (20 cases) from that due to aortic valvular stenosis (10 cases) or systemic hypertension (10 cases). In aortic stenosis or hypertension symmetrical left ventricular hypertrophy was demonstrated with greater than normal thickness of both the ventricular septum and the posterior ventricular wall. The ratio of septal-to-posterior ventricular-wall thickness (mean ± S.D.) was the same as normal (1.2 ± 0.1). In hypertrophic cardiomyopathy, asymmetrical left ventricular hypertrophy was demonstrated with gross septal thickening (22.5 ± 3.4 mm) and a normal or slightly increased thickness of the posterior left ventricular wall (10.4 ± 2.0 mm). The ratio of septal-to-posterior left-ventricular-wall thickness (2.2 ± 0.2) was greater than that in aortic stenosis or systemic hypertension (p<0.005). The ventricular septum was disproportionately hypertrophied in hypertrophie cardiomyopathy regardless of the presence or absence of left ventricular outflow obstruction. (N Engl J Med 289:118–121, 1973)