Electrocardiography for Assessment of Hypertensive Heart Disease: A New Role for an Old Tool

摘要

Left ventricular (LV) hypertrophy (LVH), detectedudeither by electrocardiography (ECG) or echocardiographyud(ECHO), has long been recognized as a powerfuludpredictor of serious cardiovascular (CV) sequelae.Audvery large and highly consistent body of evidenceudindicates that LVH is not only an adaptation toudincreased hemodynamic load in hypertension, but isudalso independently associated with an enhanced risk forudmyocardial infarction, cardiac sudden death, congestiveudheart failure, and stroke in the general population, asudwell as in patients with systemic hypertension, coronaryudheart disease, chronic kidney disease, and atrial fibrillation. Intriguingly, the cumulative incidence ofudcardiovascular events increases progressively withudincreasing LV mass (LVM), without evidence of anyudthreshold separating the postulated “compensatory”udfrom “pathological” LVH. In other words, patientsudwith LVM in the upper-normal range already haveudincreased risk for CV events.