[Echocardiographic evaluation of ventricular hypertrophy]

Abstract

Quantitative echocardiography is the gold standard for the evaluation of abnormalities in left ventricular (LV) geometry and systolic function, information very important for risk stratification, and also applicable in clinical practice when some conditions are met. Few primary measures (LV diameter, septal and posterior wall thickness) provide a valuable information which fully represents the type and degree of hemodynamic alteration. These measures should be collected ideally by M-mode tracings, but often M-mode examination cannot be performed. When M-mode is suboptimal, LV mass can be computed using two-dimensional imaging and the formulas used for M-mode. LV mass is expressed as an index normalized for some measure of body size. Normalization for height in meters to the power 2.7 can identify a higher proportion of individuals at high cardiovascular risk and provides a greater attributable risk than other methods of indexation. When LV hypertrophy develops to provide sufficient strength to compensate for hemodynamic overload, the increase in LV mass is not clearly associated with increased cardiovascular risk. In contrast, individuals with LV mass inappropriately high as compared to the value sufficient to compensate for hemodynamic load at a given body size present with a phenotype characterized by high cardiovascular risk, even in the absence of arterial hypertension.