title: Prevalence, clinical correlates, and prognosis of discrete upper septal thickening on echocardiography: the Framingham Heart Study.
abstract: The upper interventricular septum may be prominent in elderly individuals, a finding referred to as discrete upper septal thickening (DUST). We examined the prevalence, clinical and echocardiographic correlates, and prognostic significance of DUST in a community-based sample. We evaluated Framingham Study participants who underwent routine echocardiography. In 3562 Framingham Study participants (mean age 58 years, 57% women), DUST was observed in 52 participants. The clinical correlates of DUST were increasing age (odds ratio [OR] per 10 year increment 2.59, 95% confidence intervals [CI] 1.64-4.08) and systolic blood pressure (OR per SD increment 1.55, 95% CI 1.15-2.09). DUST was positively associated with left ventricular (LV) fractional shortening and mitral annular calcification but inversely with LV diastolic dimensions (P < 0.02 for all). On follow-up (mean 15 years), 732 individuals died (33 with DUST) and 560 experienced a cardiovascular disease (CVD) event (18 with DUST). Adjusting for cardiovascular risk factors, DUST was not associated with CVD or mortality risk (P > 0.30 for both). The follow-up component of our study suggests that DUST is not independently associated with adverse prognosis.
authors.affiliation: Framingham Heart Study, National Heart, Lung and Blood Institute, Framingham, MA 01702, USA.
authors.forename: Tulio
authors.initials: T
authors.lastname: Diaz
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pencina
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Jayashri
authors.initials: J
authors.lastname: Aragam
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Fuller
authors.forename: Karol M
authors.initials: KM
authors.lastname: Pencina
authors.forename: Daniel
authors.initials: D
authors.lastname: Levy
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic