Maron B J, Edwards J E, Epstein S E
Chest. 1978 Apr;73(4):466-70. doi: 10.1378/chest.73.4.466.
To determine the prevalence and characteristics of disproportionate ventricular septal thickening (septal-free wall ratio of greater than or equal to 1.3) in a population of patients with severe chronic hypertension, which was unassociated with coronary arterial disease, 33 patients were studied at necropsy. The overall prevalence of disproportionate septal thickening was relatively low, ie, two (6 percent) of the 33 patients. The septal-free wall ratio in both of these patients was 1.3. Disproportionate septal thickening appeared to be secondary to the left ventricular pressure overload, rather than to coexistent genetically transmitted hypertrophic cardiomyopathy. This conclusion was based on the following facts: (1) numerous disorganized cardiac muscle cells, characteristic of hypertrophic cardiomyopathy, were not present in the ventricular septum of either patient with disproportionate septal thickening; and (2) echocardiographic studies performed in first-degree relatives of one of the two patients did not disclose disproportionate septal thickening. Hence, disproportionate septal thickening may occur as a secondary manifestation of left ventricular pressure overload that is present in patients with systemic hypertension, but this association appears to be relatively uncommon.
为了确定在患有严重慢性高血压且与冠状动脉疾病无关的患者群体中不成比例的室间隔增厚（室间隔与游离壁厚度比大于或等于1.3）的患病率和特征，对33例患者进行了尸检研究。不成比例的间隔增厚的总体患病率相对较低，即33例患者中有2例（6%）。这两名患者的室间隔与游离壁厚度比均为1.3。不成比例的间隔增厚似乎继发于左心室压力超负荷，而非并存的遗传性肥厚型心肌病。这一结论基于以下事实：（1）两名不成比例间隔增厚患者的室间隔中均不存在大量肥厚型心肌病特有的紊乱心肌细胞；（2）对两名患者之一的一级亲属进行的超声心动图研究未发现不成比例的间隔增厚。因此，不成比例的间隔增厚可能是系统性高血压患者存在的左心室压力超负荷的继发表现，但这种关联似乎相对少见。
