Echocardiography-based left ventricular mass estimation. How should we define hypertrophy?

Abstract

Left ventricular hypertrophy is an important risk factor in cardiovascular disease and echocardiography has been widely used for diagnosis. Although an adequate methodologic standardization exists currently, differences in measurement and interpreting data is present in most of the older clinical studies. Variability in border limits criteria, left ventricular mass formulas, body size indexing and other adjustments affects the comparability among these studies and may influence both the clinical and epidemiologic use of echocardiography in the investigation of the left ventricular structure. We are going to review the most common measures that have been employed in left ventricular hypertrophy evaluation in the light of some recent population based echocardiographic studies, intending to show that echocardiography will remain a relatively inexpensive and accurate tool diagnostic tool.

Figure 1

Comparison between M-mode border measurement conventions. The Standard convention measures from leading to trailing edge in the septum and from leading to leading edge of the posterior wall. Penn criteria excludes echoes from parietal walls while ASE criteria measure leading to leading edge. (LVDd: Left Ventricular Diameter in Diastole).

Figure 2

Geometric Patterns.