2023 Volume 50 Issue 5 Pages 309-318
Left ventricular (LV) hypertrophy is not uncommonly discovered incidentally on electrocardiograms taken as part of medical checkups. Echocardiography is the safest and most effective examination method for diagnosing it and searching for the cause. The causes of LV hypertrophy are various, including extrinsic factors such as pressure overload and volume overload, genetic factors, and deposition of abnormal substances. Because LV hypertrophy is a predictor of cardiovascular events and prognosis, it is of great clinical importance to assess the degree of LV hypertrophy. LV hypertrophy does not mean only thickening of the LV wall but also an increase in the mass of the entire myocardium due to enlargement of individual myocardial cells. LV hypertrophy is classified into concentric hypertrophy and eccentric hypertrophy according to relative wall thickness and left ventricular mass index (LVMI). LVMI is measured using either the linear method or the tomographic method. The tomographic method is recommended when the LV is morphologically abnormal. Whichever method is used, accurate measurement of the LV wall thickness and lumen is important. It is fundamental to measure them at the correct position and not to mistakenly measure other structures inside the ventricles. The cause of LV hypertrophy is determined based on the degree of the LV wall thickness and its distribution. However, it is difficult to specify the cause of LV hypertrophy based solely on echocardiography, and it is important to make a comprehensive judgment together with family history, physical findings, and various examinations.
