Second statement of the Working Group on Electrocardiographic Diagnosis of Left Ventricular Hypertrophy

Bachárová, Ljuba; Estes, E. Harvey; Bang, Lia E.; Hill, Joseph A.; Macfarlane, Peter W.; Rowlandson, Ian; Schillaci, Giuseppe

doi:10.1016/j.jelectrocard.2011.06.005

Cited by 44 publications

(25 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently, the estimation of LV mass or LV dimensions can be imprecise. 15 The presence of LVH usually means more than an increase in LV mass and can produce, as previously stated, prolonged duration of QRS complex, left axis deviation, increased intrinsicoid deflection on left precordial leads, and intraventricular conduction defects such as left bundle-branch block (LBBB) or left anterior fascicular block.…”

Section: Introductionmentioning

confidence: 91%

See 1 more Smart Citation

Electrical remodeling in left ventricular hypertrophy—is there a unifying hypothesis for the variety of electrocardiographic criteria for the diagnosis of left ventricular hypertrophy?

Padial

Bachárová

2012

Journal of Electrocardiology

Self Cite

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 91%

“…Because all this information can be obtained from the ECG, it appears to be inappropriate to use the ECG only for estimating LV mass. 15 As a consequence, future research should be aimed at further analyzing the relationship between these 3 components and the impact that each of them could have on prognosis.…”

Section: Introductionmentioning

confidence: 99%

Electrical remodeling in left ventricular hypertrophy—is there a unifying hypothesis for the variety of electrocardiographic criteria for the diagnosis of left ventricular hypertrophy?

Padial

Bachárová

2012

Journal of Electrocardiology

Self Cite

View full text Add to dashboard Cite

“…19 Since the hypertrophied myocardium is pathologically altered in more ways than just increase mass, it is apparent that ECG LVH has to move beyond estimation of LV mass. 20 With regards to the physiological basis for generating the ECG, it has been documented that the conduction velocity in the hypertrophied LV myocardium is slower than normal. [21][22][23] The slowing in conduction velocity is understood to be a determinant of QRS duration prolongation.…”

Section: Cmr In Understanding the Ecg In Lvhmentioning

confidence: 99%

Left Ventricular Hypertrophy: The Relationship between the Electrocardiogram and Cardiovascular Magnetic Resonance Imaging

Bachárová

2014

Noninvasive Electrocardiol

Self Cite

View full text Add to dashboard Cite

Conventional assessment of left ventricular hypertrophy (LVH) using the electrocardiogram (ECG), for example, by the Sokolow-Lyon, Romhilt-Estes or Cornell criteria, have relied on assessing changes in the amplitude and/or duration of the QRS complex of the ECG to quantify LV mass. ECG measures of LV mass have typically been validated by imaging with echocardiography or cardiovascular magnetic resonance imaging (CMR). However, LVH can be the result of diverse etiologies, and LVH is also characterized by pathological changes in myocardial tissue characteristics on the genetic, molecular, cellular, and tissue level beyond a pure increase in the number of otherwise normal cardiomyocytes. For example, slowed conduction velocity through the myocardium, which can be due to diffuse myocardial fibrosis, has been shown to be an important determinant of conventional ECG LVH criteria regardless of LV mass. Myocardial tissue characterization by CMR has emerged to not only quantify LV mass, but also detect and quantify the extent and severity of focal or diffuse myocardial fibrosis, edema, inflammation, myocarditis, fatty replacement, myocardial disarray, and myocardial deposition of amyloid proteins (amyloidosis), glycolipids (Fabry disease), or iron (siderosis). This can be undertaken using CMR techniques including late gadolinium enhancement (LGE), T1 mapping, T2 mapping, T2* mapping, extracellular volume fraction (ECV) mapping, fat/water-weighted imaging, and diffusion tensor CMR. This review presents an overview of current and emerging concepts regarding the diagnostic possibilities of both ECG and CMR for LVH in an attempt to narrow gaps in our knowledge regarding the ECG diagnosis of LVH. Ann Noninvasive Electrocardiol 2014;19(6):524-533 noninvasive techniques; electrocardiography; cardiac MRIThe diagnosis of left ventricular hypertrophy (LVH) in clinical practice is a finding that requires the attention of the clinician. It has been documented that LVH detected by echocardiography or the electrocardiogram (ECG) is a risk factor for cardiac morbidity or mortality which is independent of other known risk factors including blood pressure and left ventricular mass. 1-3In hypertensive patients, the finding of LVH in a patient has a direct impact on therapy. LVH detected by both echocardiography and ECG define target organ damage, and according to the European Society of Cardiology guidelines 4 the Address for correspondence : Ljuba Bacharova, M.D., D.S.c., M.B.A., International Laser Center, Ilkovicova 3, 841 presence of target organ damage is a key factor in the management of the hypertensive patient. It has also been shown that antihypertensive therapy decreases signs of LVH by echocardiography or ECG that are associated with improvement of the clinical status and prognosis of a hypertensive patient, [5][6][7] and thus the benefit of antihypertensive therapy can be monitored. However, these straightforward statements lead to a number of unanswered questions.It has repeatedly been documented that the diagnostic perform...

show abstract

“…The aim of this review is to provide an overview of the complex biology of left ventricular hypertrophy with an eye toward enhancing our understanding of its ECG manifestations. 3,4 Hypertrophic growth of the cardiac myocyte Whereas recent work has revealed that a small fraction of cells within the ventricle are capable of re-entering the cell cycle, 5-7 the vast majority of cardiac myocytes are postmitotic and hence do not retain the ability to divide. Rather, they respond to stress by growing, shrinking, or dying.…”

Section: Introductionmentioning

confidence: 99%

Hypertrophic reprogramming of the left ventricle: translation to the ECG

Hill

2012

Journal of Electrocardiology

Self Cite

View full text Add to dashboard Cite

Hypertrophic growth of the heart occurs in many clinical scenarios, and it confers substantially increased risk of untoward sequelae. Among them, transition to ventricular dilation, wall thinning, contractile dysfunction, and a clinical syndrome of heart failure is paramount. Left ventricular hypertrophy (LVH) is typically diagnosed by either electrocardiography or echocardiography. However, these two means of assessing hypertrophic transformation of the left ventricle can sometimes disagree. At one level, this may not be surprising as the two methodologies are based on entirely divergent signals: electrical potential between two places on the surface of the skin and ultrasound energy reflected from the ventricle itself. Echocardiography is an effective means of assessing ventricular mass, which is a cardinal feature of LVH. Importantly, however, LVH is characterized by a wide range of remodeling events beyond simple increases in muscle mass. Electrocardiographic changes in LVH are reflective of the electrophysiological aspects of hypertrophic transformation. Here, I present an overview of the complex biology of left ventricular hypertrophy with an eye toward enhancing our understanding of its ECG manifestations.

show abstract

Second statement of the Working Group on Electrocardiographic Diagnosis of Left Ventricular Hypertrophy

Cited by 44 publications

References 8 publications

Electrical remodeling in left ventricular hypertrophy—is there a unifying hypothesis for the variety of electrocardiographic criteria for the diagnosis of left ventricular hypertrophy?

Electrical remodeling in left ventricular hypertrophy—is there a unifying hypothesis for the variety of electrocardiographic criteria for the diagnosis of left ventricular hypertrophy?

Left Ventricular Hypertrophy: The Relationship between the Electrocardiogram and Cardiovascular Magnetic Resonance Imaging

Hypertrophic reprogramming of the left ventricle: translation to the ECG

Contact Info

Product

Resources

About