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Diagnosis of left ventricular hypertrophy by echocardiography
1Department of Cardiology, University of Heidelberg, Germany.
Insights
Diagnosing left ventricular hypertrophy (LVH) is crucial for cardiovascular health. Echocardiography is the standard method, with specific mass values defining LVH in males and females.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Left ventricular hypertrophy (LVH) in systemic arterial hypertension significantly elevates cardiovascular morbidity and mortality risks.
- Accurate diagnosis of LVH is clinically essential for patient management.
Purpose of the Study:
- To review current echocardiographic techniques for measuring left ventricular mass.
- To outline diagnostic criteria for LVH based on M-mode and 2D echocardiography.
Main Methods:
- Review of M-mode echocardiography techniques for left ventricular mass estimation.
- Review of two-dimensional (2D) echocardiography techniques for left ventricular mass estimation.
Main Results:
- LVH is typically diagnosed with M-mode when myocardial mass exceeds 150 g/m² (males) or 120 g/m² (females).
- Using 2D echocardiography, upper limits are lower: 102 g/m² (males) and 88 g/m² (females).
- Variability in 2D echocardiographic LV mass estimates is primarily due to image acquisition and quantitation, with potential SD of 35 g in serial studies.
Conclusions:
- Echocardiography is the primary tool for LVH diagnosis.
- Standardized measurement protocols and increased reader/technician involvement can reduce variability in LV mass assessment.
Abstract:
Left ventricular hypertrophy in systemic arterial hypertension is associated with an increased risk of morbidity and mortality due to cardiovascular disease. Therefore, the diagnosis of left ventricular hypertrophy is clinically important. In current clinical practice, echocardiography is the method of choice for diagnosing left ventricular hypertrophy. This review describes current, clinically applied techniques of measuring left ventricular mass using M-mode and two-dimensional echocardiography. Using M-mode techniques, left ventricular hypertrophy is usually present when myocardial mass estimates exceed 150 g/m2 in males and 120 g/m2 in females. Using two-dimensional echocardiography, upper limits of normal have been described to be slightly lower (102 g/m2 in males and 88 g/m2 in females). In serial clinical two-dimensional echocardiographic studies, image acquisition and quantitation predominantly determine total variability in left ventricular mass estimates. Using any single technician and any single reader, left ventricular mass estimates in normal subjects may vary by 35 g (standard deviation) between serial studies. Strategies to reduce the magnitude of this variability include increasing the number of technicians and readers acquiring and analyzing a single study.