Authors

• Vlatka Rešković Lukšić — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0002-4721-3236
• Karla Pavlović — University of Zagreb, Zagreb, Croatia
• Marijan Pašalić — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0002-3197-2190
• Jadranka Šeparović Hanževački — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0002-3437-6407

Abstract

**Background**: Basal septal hypertrophy (BHS) is one of the first signs of concentric left ventricular remodeling in chronic pressure overload such as arterial hypertension (AH) (1). Aim: To investigate if the appearance of BHS in the early course of AH correlates with outcomes in the long-term follow-up. **Patients and Methods**: A total of 138 patients with primary AH, aged less than 65 years and with no comorbidities were included during 2014-2017. Patients were divided into two groups according to BSH presence on the transthoracic echocardiography. Follow-up was performed by checking patients’ hospital data charts and telephone interview. Data concerning antihypertensive drug therapy and cardiovascular morbidity was collected. **Results:** Basal septal hypertrophy was found in half of the patients (53.6%). Mean follow-up period was 91.92±7.20 months. At the time of follow-up, mean age was 56.09±11.68 years, patients with BSH were older (p=0.004). In the whole cohort, mean number of antihypertensive drugs at baseline was 2.01±1.29, in the follow up 1.81±1.14 (**Figure 1**). BSH patients were altogether taking more antihypertensive drugs (2.10±1.26 vs 1.53±0.94, p=0.032), more diuretics (p=0.014), angiotensin converting enzyme inhibitors (p=0.007) and beta-blockers (p=0.004). In the follow-up period, hospitalizations, or referrals to emergency department due to cardiovascular events, stroke or transient ischemic attack, intracranial hemorrhage and newly diagnosed coronary artery disease and atrial fibrillation were noted in both groups, **Figure 2**. Even though those outcomes were more frequent in the BSH group, there was no significant difference, probably due to a small number of included patients and relatively short follow-up period. FIGURE 1. Distribution of antihypertensive drug therapy in the whole cohort. ACEi = angiotensin converting enzyme inhibitors, ARB = angiotensin receptor blockers, CCB = calcium channel blockers, BB = beta-blockers. FIGURE 2. Outcomes in patients with and without basal septal hypertrophy. BSH = basal septal hypertrophy, CV = cardiovascular, CVI = stroke, TIA = transient ischemic attack, SAH = subarachnoid hemorrhage, AFib = atrial fibrillation. **Conclusion:** Appearance of BSH is found to be a macroscopic marker of the incipient regional and global left ventricular remodeling and dysfunction in chronic pressure overload, but it could also be a potential marker of adverse outcomes in the long-term follow-up. Lower total amount of antihypertensive therapy in the follow-up may imply lower patient’s compliance.

Keywords

arterial hypertension, basal septal hypertrophy

DOI

Literature

1. Separovic Hanzevacki J, Reskovic Luksic V. Specific deformation pattern in hypertensive patients with septal bulge and preserved systolic function. Int J Cardiovasc Imaging. 2022 November;38(11):2323–31. https://doi.org/10.1007/s10554-022-02662-4