Echocardiographic features of secondary left ventricular hypertrophy.

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Abstract
Echocardiograms showing left ventricular cavity and mitral valve were recorded and digitized in 100 patients with secondary left ventricular hypertrophy caused by severe hypertension (23), aortic valve stenosis (21), fixed subaortic stenosis (13), postoperative aortic stenosis (13) or regurgitation (30). Left ventricular dimension and its rate of change were determined and related to mitral valve opening. The values were compared with those from 30 patients with hypertrophic cardiomyopathy. In patients with secondary left ventricular hypertrophy, cavity size and peak circumferential fiber shortening rate were normal. In diastole the peak rate of increase of dimension was reduced in 56, and mitral valve opening normally synchronous with minimum dimension was delayed in 78 and were due to abnormal left ventricular relaxation. The septal to posterior wall thickness ratio was 1.3 in 40. Values for delay in mitral valve opening were distributed bimodally in the population of patients with secondary left ventricular hypertrophy with 1 subgroup in which it was normal and the other in which it was significantly delayed. The distribution of the latter along with those of values of peak rate of dimension increase and septal to posterior wall thickness ratio were indistinguishable from those in the patients with hypertrophic cardiomyopathy. Abnormalities similar to those of hypertrophic cardiomyopathy occur in patients with secondary left ventricular hypertrophy and echocardiographic criteria cannot distinguish the 2 conditions.