Evaluation of Discrete Upper Septal Thickening on 64-Slice Coronary Computed Tomographic Angiography

Abstract

Discrete upper septal thickening (DUST) has been well described in the echocardiology literature. To our knowledge, the computed tomography findings of DUST, however, have not been previously described. Five hundred consecutive coronary computed tomography angiograms were evaluated by 2 cardiothoracic radiologists for the presence of DUST. Of the 500 studies reviewed, 23 cases had features consistent with DUST (23/500 = 5%). The average systolic blood pressure of patients with DUST (150/77 mm Hg) was higher than that of patients without DUST (133/75 mm Hg). Patients with DUST were older (mean 63 y) than patients without DUST (mean 50 y). None of these patients had evidence of abnormal systolic anterior motion of the mitral valve on cine imaging. DUST is seen on coronary computed tomography angiograms and has imaging characteristics distinct from significant pathology, such as hypertrophic cardiomyopathy. Recognizing DUST is important because, unlike hypertrophic cardiomyopathy, previous studies have not found an associated adverse prognosis with DUST.