Echocardiographic interventricular septal wall motion and thickness: A study in health and disease

Abstract

The interventricular septal wall thickness and motion was studied by echocardiography in 25 normal subjects and 43 patients with various cardiovascular disease proved at cardiac catheterization. The mean septal thickness was 7.2 mm. ± 0.7 S.D. in the normal subjects, 10,1 mm. ± 1.0 S.D. in 11 patients with left ventricular volume overload (P < 0.01), and a mean of 12.2 mm. in two patients with pure pressure overload of the left ventricle. Ten patients with coronary atherosclerotic heart disease (CAHD) had an average septal thickness of 9.2 mm. ± 1.1 S.D. and in five patients with congestive cardiomyopathy (CM) it was 9.1 mm. ± 0.8 S.D., and a mean of 17.8 mm. in four patients with IHSS (P < 0.01). In five patients with mitral stenosis the septal thickness did not differ from normal (mean 7.1 mm. ± 0.9 S.D.). Septal motion was correlated with angiographic ejection fraction, pattern of left ventricular wall motion, and coronary angiography. All patients with left ventricular disease and an abnormal septal motion invariably had significant left ventricular dysfunction at cardiac catheterization, particularly patients with CM or severe CAHD, although a normal septal motion does not exclude severe left ventricular dysfunction and hypokinesis. It is concluded that study of the interventricular septum by echocardiography provides a non-invasive technique with a high specificity but a lower sensitivity for identifying patients with left ventricular dysfunction.