Refine
Has Fulltext
- yes (57)
Is part of the Bibliography
- yes (57)
Year of publication
Document Type
- Journal article (57)
Language
- English (57) (remove)
Keywords
- heart failure (14)
- mortality (5)
- echocardiography (4)
- myocardial infarction (4)
- amyloidosis (3)
- chronic kidney disease (3)
- cognitive impairment (3)
- coronary artery disease (3)
- ejection fraction (3)
- guideline adherence (3)
- hypertension (3)
- prognosis (3)
- GFAP (2)
- acute heart failure (2)
- anxiety (2)
- cardiac magnetic resonance imaging (2)
- cardiac surgery (2)
- cardiomyopathy (2)
- coronary heart disease (2)
- deformation (2)
- depression (2)
- diagnosis (2)
- glial fibrillary acidic protein (2)
- guidelines (2)
- ischemic stroke (2)
- left ventricular ejection fraction (2)
- management (2)
- myocardial work (2)
- neurofilament light chain (2)
- prevalence (2)
- quality of life (2)
- validation (2)
- 2-dimensional speckle tracking (1)
- ACC/AHA classification (1)
- AKI (1)
- Akutes Nierenversagen (1)
- Alzheimer's disease (1)
- Alzheimer’s dementia (1)
- BDNF (1)
- Brain atrophy (1)
- COMT (1)
- COPD diagnosis (1)
- COVID-19 (1)
- Cardiac dysfunction| Brain natriuretic peptide (1)
- CardioMEMS™ HF-System (1)
- Cardiovascular magnetic-resonance (1)
- Cardiovascular risk factors (1)
- Cardiovascular risk prediction (1)
- Carotid intima-media thickness (CIMT) (1)
- Carotid segment (1)
- Carotid ultrasound (1)
- Chronic heart failure (1)
- Cognitive decline (1)
- Coronary artery disease (1)
- Diastocic Dysfunction (1)
- ESC (1)
- EUROASPIRE survey (1)
- Enzyme replacement therapy (1)
- Eplerenone (1)
- Framingham (1)
- GDNF (1)
- GOLD (1)
- Glial fibrillary acidic protein (1)
- Guidelines (1)
- Heart failure (1)
- HiGHmed (1)
- Hyperkalemia (1)
- Hypertrophic cardiomyopathy (1)
- ICD-coding of CKD (1)
- Internet of Things devices (1)
- KDIGO (1)
- LV dilatation (1)
- MRI (1)
- Management (1)
- Manifestation (1)
- Medizin (1)
- Memory dysfunction (1)
- Morbidity (1)
- Mortality (1)
- Myocardial fibrosis (1)
- Myocardial-Infarction (1)
- NT‐proBNP (1)
- NfL (1)
- Outcomes (1)
- Predictors (1)
- Preserved Ejection Fraction (1)
- SGLT2 inhibitors (1)
- ST-elevation myocardial infarction (1)
- STEMI (1)
- Septal bulge (1)
- Stroke (1)
- Task force (1)
- Troponin (1)
- Ventricular-arrhythmias (1)
- accuracy (1)
- acute decompensated heart failure (1)
- acute kidney injury (1)
- adaptive immune response (1)
- age (1)
- age-related hearing loss (1)
- amyloid cardiomyopathy (1)
- anaemia (1)
- anti-myocardial (1)
- aortic valve stenosis (1)
- arterial stiffening (1)
- atherosclerosis (1)
- atrial fibrillation (1)
- autoantibody (1)
- awareness (1)
- biomarker (1)
- biomarkers (1)
- blood coagulation factor XIII (1)
- blood lipids (1)
- blood pressure (1)
- blood pressure monitoring (1)
- blood-glucose (1)
- blood–brain barrier (1)
- blood–labyrinth barrier (1)
- bull’s eye plot (1)
- calcification (1)
- calcium imaging (1)
- cardiac arrest (1)
- cardiac glycosides (1)
- cardiac training group (1)
- cardiac transplantation (1)
- cardiopulmonary bypass (1)
- cardiovascular care (1)
- cardiovascular diseases (1)
- cardiovascular magnetic resonance (1)
- cardiovascular risk factors (1)
- carotid artery disease (1)
- chronic heart failure (1)
- chronic heart failure (CHF) (1)
- chronic thromboembolic pulmonary hypertension (1)
- clinical data warehouse (1)
- clinical manifestations (1)
- clinical routine data (1)
- clinical study (1)
- clinical systems (1)
- clinical trial (1)
- cluster analysis (1)
- coaptation line (1)
- comorbidity (1)
- comparability (1)
- congestion (1)
- data warehouse (1)
- death rates (1)
- dementia (1)
- diagnostic medicine (1)
- digital Health (1)
- digital phenotyping (1)
- digitalis (1)
- digitoxin (1)
- disease (1)
- disease score (1)
- disease severity (1)
- dynamic (1)
- ecological momentary assessment (1)
- electronic data capture (1)
- electronic health records (1)
- euroaspire (1)
- evidence-based practice (1)
- fabry disease (1)
- feasibility (1)
- fibrosis (1)
- follow-up (1)
- functional regurgitation (1)
- glial damage (1)
- glucose control (1)
- glycaemic control (1)
- guideline implementation (1)
- guideline-directed medical therapy (1)
- healing and remodelling processes (1)
- health care research (1)
- health economics (1)
- health policy (1)
- health questionnaire (1)
- health risk assessment (1)
- heart (1)
- heart disease (1)
- heart failure training group (1)
- heart rate variability (1)
- heme oxygenase-1 (1)
- home telemonitoring (1)
- hospitalization (1)
- human behaviour (1)
- identification (1)
- impact (1)
- incremental cost-effectiveness ratio (ICER) (1)
- infarction size (1)
- inferior vena cava (1)
- inflammation (1)
- information extraction (1)
- intensity of attention (1)
- internal medicine (1)
- ischemic (1)
- leaflet (1)
- left ventricular geometric abnormality (1)
- left ventricular geometry (1)
- left ventricular hypertrophy (1)
- left ventricular mass (1)
- left ventricular performance (1)
- left ventricular remodeling (1)
- longitudinal studies (1)
- lower limit of normal (1)
- m exercise training (1)
- mHealth (1)
- medical data integration center (1)
- medical informatics initiative (1)
- medication extraction (1)
- mellitus (1)
- metaanalysis (1)
- mineralocorticoid antagonist (1)
- mitral valve (1)
- mobile crowdsensing (1)
- mobile health (1)
- morbidity (1)
- motion detector (1)
- music performance anxiety (1)
- myocardial work efficiency (1)
- myocardial fibrosis (1)
- natriuretic peptide (1)
- neuroinflammation (1)
- neurotrophins (1)
- noncontact monitoring (1)
- normal values (1)
- observational study (1)
- oncology (1)
- openEHR (1)
- outcomes (1)
- patients’ awareness (1)
- pharmacotherapy (1)
- phosphorylated tau protein (1)
- physicians’ awareness (1)
- point-of-care echocardiography (1)
- population (1)
- population-based study (1)
- postoperativ (1)
- preserved ejection fraction (1)
- primary prevention (1)
- progressive muscle relaxation (1)
- pulmonary artery pressure (1)
- randomized controlled trial (1)
- real-world (1)
- recovery (1)
- reference data (1)
- regression analysis (1)
- remote monitoring (1)
- renal function (1)
- risk factor control (1)
- risk factors (1)
- risk prediction scores (1)
- sacubitril-valsartan (1)
- scale (1)
- secondary data usage (1)
- secondary prevention (1)
- semantic interoperability (1)
- sex differences (1)
- sodium-glucose co-transporter-2 inhibitors (1)
- speckle tracking imaging (1)
- speech recognition (1)
- spiral ganglion neuron (1)
- standardization (1)
- stem cell transplantation (1)
- stroke unit (1)
- systolic dysfunction (1)
- task force (1)
- telemedicine (1)
- tenting (1)
- therapeutic approach (1)
- therapy (1)
- three-dimensional echocardiography (1)
- treatment (1)
- tricuspid pressure gradient (1)
- troponin (1)
- troponin T (1)
- type 2 diabetes (1)
- ultrasound (1)
- usability (1)
- user-centered design (1)
- validity (1)
- virtual reality exposure therapy (1)
Institute
- Medizinische Klinik und Poliklinik I (49)
- Deutsches Zentrum für Herzinsuffizienz (DZHI) (30)
- Institut für Klinische Epidemiologie und Biometrie (18)
- Neurologische Klinik und Poliklinik (7)
- Institut für Informatik (6)
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie (6)
- Klinik und Poliklinik für Thorax-, Herz- u. Thorakale Gefäßchirurgie (6)
- Medizinische Klinik und Poliklinik II (5)
- Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) (4)
- Institut für Virologie und Immunbiologie (3)
- Institut für diagnostische und interventionelle Neuroradiologie (ehem. Abteilung für Neuroradiologie) (3)
- Institut für Hygiene und Mikrobiologie (2)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (2)
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (2)
- Abteilung für Molekulare Innere Medizin (in der Medizinischen Klinik und Poliklinik II) (1)
- Comprehensive Cancer Center Mainfranken (1)
- Institut für Pharmakologie und Toxikologie (1)
- Institut für Psychologie (1)
- Institut für Sportwissenschaft (1)
- Institut für medizinische Datenwissenschaften (1)
- Pathologisches Institut (1)
- Universität Würzburg (1)
Sonstige beteiligte Institutionen
Prospective longitudinal follow‐up of left ventricular ejection fraction (LVEF) trajectories after acute cardiac decompensation of heart failure is lacking. We investigated changes in LVEF and covariates at 6‐months' follow‐up in patients with a predischarge LVEF ≤40%, and determined predictors and prognostic implications of LVEF changes through 18‐months' follow‐up.
Methods and Results
Interdisciplinary Network Heart Failure program participants (n=633) were categorized into subgroups based on LVEF at 6‐months' follow‐up: normalized LVEF (>50%; heart failure with normalized ejection fraction, n=147); midrange LVEF (41%–50%; heart failure with midrange ejection fraction, n=195), or persistently reduced LVEF (≤40%; heart failure with persistently reduced LVEF , n=291). All received guideline‐directed medical therapies. At 6‐months' follow‐up, compared with patients with heart failure with persistently reduced LVEF, heart failure with normalized LVEF or heart failure with midrange LVEF subgroups showed greater reductions in LV end‐diastolic/end‐systolic diameters (both P<0.001), and left atrial systolic diameter (P=0.002), more increased septal/posterior end‐diastolic wall‐thickness (both P<0.001), and significantly greater improvement in diastolic function, biomarkers, symptoms, and health status. Heart failure duration <1 year, female sex, higher predischarge blood pressure, and baseline LVEF were independent predictors of LVEF improvement. Mortality and event‐free survival rates were lower in patients with heart failure with normalized LVEF (P=0.002). Overall, LVEF increased further at 18‐months' follow‐up (P<0.001), while LV end‐diastolic diameter decreased (P=0.048). However, LVEF worsened (P=0.002) and LV end‐diastolic diameter increased (P=0.047) in patients with heart failure with normalized LVEF hospitalized between 6‐months' follow‐up and 18‐months' follow‐up.
Conclusions
Six‐month survivors of acute cardiac decompensation for systolic heart failure showed variable LVEF trajectories, with >50% showing improvements by ≥1 LVEF category. LVEF changes correlated with various parameters, suggesting multilevel reverse remodeling, were predictable from several baseline characteristics, and were associated with clinical outcomes at 18‐months' follow‐up. Repeat hospitalizations were associated with attenuation of reverse remodeling."
Aims
Despite recent advances in the treatment of chronic heart failure (HF), mortality and hospitalizations still remain high. Additional therapies to improve mortality and morbidity are urgently needed. The efficacy of cardiac glycosides – although regularly used for HF treatment – remains unclear. DIGIT-HF was designed to demonstrate that digitoxin on top of standard of care treatment improves mortality and morbidity in patients with HF and a reduced ejection fraction (HFrEF).
Methods
Patients with chronic HF, New York Heart Association (NYHA) functional class III–IV and left ventricular ejection fraction (LVEF) ≤ 40%, or patients in NYHA functional class II and LVEF ≤ 30% are randomized 1:1 in a double-blind fashion to treatment with digitoxin (target serum concentration 8–18 ng/mL) or matching placebo. Randomization is stratified by centre, sex, NYHA functional class (II, III, or IV), atrial fibrillation, and treatment with cardiac glycosides at baseline. A total of 2190 eligible patients will be included in this clinical trial (1095 per group). All patients receive standard of care treatment recommended by expert guidelines upon discretion of the treating physician. The primary outcome is a composite of all-cause mortality or hospital admission for worsening HF (whatever occurs first). Key secondary endpoints are all-cause mortality, hospital admission for worsening HF, and recurrent hospital admission for worsening HF.
Conclusion
The DIGIT-HF trial will provide important evidence, whether the cardiac glycoside digitoxin reduces the risk for all-cause mortality and/or hospital admission for worsening HF in patients with advanced chronic HFrEF on top of standard of care treatment.
Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing such an app is not trivial, necessitates strict regulatory and legal requirements, and requires short development cycles to appropriately react to abrupt changes in the pandemic. Based on an existing app framework, we developed Corona Health, an app that serves as a platform for deploying questionnaire-based studies in combination with recordings of mobile sensors. In this paper, we present the technical details of Corona Health and provide first insights into the collected data. Through collaborative efforts from experts from public health, medicine, psychology, and computer science, we released Corona Health publicly on Google Play and the Apple App Store (in July 2020) in eight languages and attracted 7290 installations so far. Currently, five studies related to physical and mental well-being are deployed and 17,241 questionnaires have been filled out. Corona Health proves to be a viable tool for conducting research related to the COVID-19 pandemic and can serve as a blueprint for future EMA-based studies. The data we collected will substantially improve our knowledge on mental and physical health states, traits and trajectories as well as its risk and protective factors over the course of the COVID-19 pandemic and its diverse prevention measures.
Background
Performance anxiety is the most frequently reported anxiety disorder among professional musicians. Typical symptoms are - on a physical level - the consequences of an increase in sympathetic tone with cardiac stress, such as acceleration of heartbeat, increase in blood pressure, increased respiratory rate and tremor up to nausea or flush reactions. These symptoms can cause emotional distress, a reduced musical and artistical performance up to an impaired functioning. While anxiety disorders are preferably treated using cognitive-behavioral therapy with exposure, this approach is rather difficult for treating music performance anxiety since the presence of a public or professional jury is required and not easily available. The use of virtual reality (VR) could therefore display an alternative. So far, no therapy studies on music performance anxiety applying virtual reality exposure therapy have investigated the therapy outcome including cardiovascular changes as outcome parameters.
Methods
This mono-center, prospective, randomized and controlled clinical trial has a pre-post design with a follow-up period of 6 months. 46 professional and semi-professional musicians will be recruited and allocated randomly to an VR exposure group or a control group receiving progressive muscle relaxation training. Both groups will be treated over 4 single sessions. Music performance anxiety will be diagnosed based on a clinical interview using ICD-10 and DSM-5 criteria for specific phobia or social anxiety. A behavioral assessment test is conducted three times (pre, post, follow-up) in VR through an audition in a concert hall. Primary outcomes are the changes in music performance anxiety measured by the German Bühnenangstfragebogen and the cardiovascular reactivity reflected by heart rate variability (HRV). Secondary outcomes are changes in blood pressure, stress parameters such as cortisol in the blood and saliva, neuropeptides, and DNA-methylation.
Discussion
The trial investigates the effect of VR exposure in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. We expect a reduction of anxiety but also a consecutive improvement of HRV with cardiovascular protective effects.
Trial registration
This study was registered on clinicaltrials.gov. (ClinicalTrials.gov Number: NCT05735860)
Background
Medication trend studies show the changes of medication over the years and may be replicated using a clinical Data Warehouse (CDW). Even nowadays, a lot of the patient information, like medication data, in the EHR is stored in the format of free text. As the conventional approach of information extraction (IE) demands a high developmental effort, we used ad hoc IE instead. This technique queries information and extracts it on the fly from texts contained in the CDW.
Methods
We present a generalizable approach of ad hoc IE for pharmacotherapy (medications and their daily dosage) presented in hospital discharge letters. We added import and query features to the CDW system, like error tolerant queries to deal with misspellings and proximity search for the extraction of the daily dosage. During the data integration process in the CDW, negated, historical and non-patient context data are filtered. For the replication studies, we used a drug list grouped by ATC (Anatomical Therapeutic Chemical Classification System) codes as input for queries to the CDW.
Results
We achieve an F1 score of 0.983 (precision 0.997, recall 0.970) for extracting medication from discharge letters and an F1 score of 0.974 (precision 0.977, recall 0.972) for extracting the dosage. We replicated three published medical trend studies for hypertension, atrial fibrillation and chronic kidney disease. Overall, 93% of the main findings could be replicated, 68% of sub-findings, and 75% of all findings. One study could be completely replicated with all main and sub-findings.
Conclusion
A novel approach for ad hoc IE is presented. It is very suitable for basic medical texts like discharge letters and finding reports. Ad hoc IE is by definition more limited than conventional IE and does not claim to replace it, but it substantially exceeds the search capabilities of many CDWs and it is convenient to conduct replication studies fast and with high quality.
Proposals for enhanced health risk assessment and stratification in an integrated care scenario
(2016)
Objectives
Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario.
Settings
The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL).
Participants
Responsible teams for regional data management in the five ACT regions.
Primary and secondary outcome measures
We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction.
Results
There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment.
Conclusions
The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require prospective evaluation.
Background:
To assess heart failure therapies in diabetic patients with preserved as compared to impaired systolic ventricular function.
Methods:
3304 patients with heart failure from 9 different studies were included (mean age 63 +/- 14 years); out of these, 711 subjects had preserved left ventricular ejection fraction (>= 50%) and 994 patients in the whole cohort suffered from diabetes.
Results:
The majority (>90%) of heart failure patients with reduced ejection fraction (SHF) and diabetes were treated with an ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) or with beta-blockers. By contrast, patients with diabetes and preserved ejection fraction (HFNEF) were less likely to receive these substance classes (p < 0.001) and had a worse blood pressure control (p < 0.001). In comparison to patients without diabetes, the probability to receive these therapies was increased in diabetic HFNEF patients (p < 0.001), but not in diabetic SHF patients. Aldosterone receptor blockers were given more often to diabetic patients with reduced ejection fraction (p < 0.001), and the presence and severity of diabetes decreased the probability to receive this substance class, irrespective of renal function.
Conclusions:
Diabetic patients with HFNEF received less heart failure medication and showed a poorer control of blood pressure as compared to diabetic patients with SHF. SHF patients with diabetes were less likely to receive aldosterone receptor blocker therapy, irrespective of renal function.
Background: International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the association between the recognition of current depression/anxiety by the general practitioner (GP) and the quality of life and the patients' prognosis.
Methods/Design: In this multicenter, prospective, observational study 3,950 patients with HF are recruited by general practices in Germany. The patients fill out questionnaires at baseline and 12-month follow-up. At baseline the GPs are interviewed regarding the somatic and psychological comorbidities of their patients. During the follow-up assessment, data on hospitalization and mortality are provided by the general practice. Based on baseline data, the patients are allocated into three observation groups: HF patients with depression and/or anxiety recognized by their GP (P+/+), those with depression and/or anxiety not recognized (P+/-) and patients without depression and/or anxiety (P-/-). We will perform multivariate regression models to investigate the influence of the recognition of depression and/or anxiety on quality of life at 12 month follow-up, as well as its influences on the prognosis (hospital admission, mortality).
Discussion: We will display the frequency of GP-acknowledged depression and anxiety and the frequency of installed therapeutic strategies. We will also describe the frequency of depression and anxiety missed by the GP and the resulting treatment gap. Effects of correctly acknowledged and missed depression/anxiety on outcome, also in comparison to the outcome of subjects without depression/anxiety will be addressed. In case results suggest a treatment gap of depression/anxiety in patients with HF, the results of this study will provide methodological advice for the efficient planning of further interventional research.
Aims Acute myocardial infarction (MI) is the major cause of chronic heart failure. The activity of blood coagulation factor XIII (FXIIIa) plays an important role in rodents as a healing factor after MI, whereas its role in healing and remodelling processes in humans remains unclear. We prospectively evaluated the relevance of FXIIIa after acute MI as a potential early prognostic marker for adequate healing.
Methods and results This monocentric prospective cohort study investigated cardiac remodelling in patients with ST-elevation MI and followed them up for 1 year. Serum FXIIIa was serially assessed during the first 9 days after MI and after 2, 6, and 12 months. Cardiac magnetic resonance imaging was performed within 4 days after MI (Scan 1), after 7 to 9 days (Scan 2), and after 12 months (Scan 3). The FXIII valine-to-leucine (V34L) single-nucleotide polymorphism rs5985 was genotyped. One hundred forty-six patients were investigated (mean age 58 ± 11 years, 13% women). Median FXIIIa was 118 % (quartiles, 102–132%) and dropped to a trough on the second day after MI: 109%(98–109%; P < 0.001). FXIIIa recovered slowly over time, reaching the baseline level after 2 to 6 months and surpassed baseline levels only after 12 months: 124 % (110–142%). The development of FXIIIa after MI was independent of the genotype. FXIIIa on Day 2 was strongly and inversely associated with the relative size of MI in Scan 1 (Spearman’s ρ = –0.31; P = 0.01) and Scan 3 (ρ = –0.39; P < 0.01) and positively associated with left ventricular ejection fraction: ρ = 0.32 (P < 0.01) and ρ = 0.24 (P = 0.04), respectively.
Conclusions FXIII activity after MI is highly dynamic, exhibiting a significant decline in the early healing period, with reconstitution 6 months later. Depressed FXIIIa early after MI predicted a greater size of MI and lower left ventricular ejection fraction after 1 year. The clinical relevance of these findings awaits to be tested in a randomized trial.
Patients in the early stage of hypertensive heart disease tend to have normal echocardiographic findings. The aim of this study was to investigate whether pathology-specific echocardiographic morphologic and functional parameters can help to detect subclinical hypertensive heart disease. One hundred ten consecutive patients without a history and medication for arterial hypertension (AH) or other cardiac diseases were enrolled. Standard echocardiography and two-dimensional speckle tracking -imaging analysis were performed. Resting blood pressure (BP) measurement, cycle ergometer test (CET), and 24-hour ambulatory BP monitoring (ABPM) were conducted. Patients were referred to "septal bulge (SB)" group (basal-septal wall thickness >= 2 mm thicker than mid-septal wall thickness) or "no-SB" group. Echocardiographic SB was found in 48 (43.6%) of 110 patients. In this SB group, 38 (79.2%) patients showed AH either by CET or ABPM. In contrast, in the no-SB group (n = 62), 59 (95.2%) patients had no positive test for AH by CET or ABPM. When AH was solely defined by resting BP, SB was a reasonable predictive sign for AH (sensitivity 73%, specificity 76%). However, when AH was confirmed by CET or ABPM the echocardiographic SB strongly predicted clinical AH (sensitivity 93%, specificity 86%). In addition, regional myocardial deformation of the basal-septum in SB group was significantly lower than in no-SB group (14 +/- 4% vs. 17 +/- 4%; P < .001). In conclusion, SB is a morphologic echocardiographic sign for early hypertensive heart disease. Sophisticated BP evaluation including resting BP, ABPM, and CET should be performed in all patients with an accidental finding of a SB in echocardiography.