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ISE/ISHNE expert co...
ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy : The change of the paradigm
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- Bacharova, Ljuba (författare)
- International Laser Center Bratislava
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- Chevalier, Philippe (författare)
- Lyon Civil Hospital / Hospices Civils de Lyon,Claude Bernard University Lyon 1
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- Gorenek, Bulent (författare)
- Eskisehir Osmangazi University
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- Jons, Christian (författare)
- Copenhagen University Hospital
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- Li, Yi Gang (författare)
- Xinhua Hospital
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- Locati, Emanuela T. (författare)
- Policlinico San Donato University Hospital
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- Maanja, Maren (författare)
- Karolinska Institutet,Karolinska University Hospital
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- Pérez-Riera, Andrés Ricardo (författare)
- Centro Universitário Central Paulista (UNICEP)
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- Platonov, Pyotr G. (författare)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Electrocardiology Research Group - CIEL,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- Ribeiro, Antonio Luiz Pinho (författare)
- Federal University of Minas Gerais
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- Schocken, Douglas (författare)
- Duke University Medical Center
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- Soliman, Elsayed Z. (författare)
- Wake Forest University
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Svehlikova, Jana (författare)
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- Tereshchenko, Larisa G. (författare)
- Cleveland Clinic Foundation
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- Ugander, Martin (författare)
- Karolinska Institute
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- Varma, Niraj (författare)
- Cleveland Clinic Foundation
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- Elena, Zaklyazminskaya (författare)
- Research Centre for Medical Genetics
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- Ikeda, Takanori (författare)
- Toho University
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: Annals of Noninvasive Electrocardiology. - 1082-720X. ; 29:1, s. e13097-
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- The ECG diagnosis of LVH is predominantly based on the QRS voltage criteria. The classical paradigm postulates that the increased left ventricular mass generates a stronger electrical field, increasing the leftward and posterior QRS forces, reflected in the augmented QRS amplitude. However, the low sensitivity of voltage criteria has been repeatedly documented. We discuss possible reasons for this shortcoming and proposal of a new paradigm. The theoretical background for voltage measured at the body surface is defined by the solid angle theorem, which relates the measured voltage to spatial and non-spatial determinants. The spatial determinants are represented by the extent of the activation front and the distance of the recording electrodes. The non-spatial determinants comprise electrical characteristics of the myocardium, which are comparatively neglected in the interpretation of the QRS patterns. Various clinical conditions are associated with LVH. These conditions produce considerable diversity of electrical properties alterations thereby modifying the resultant QRS patterns. The spectrum of QRS patterns observed in LVH patients is quite broad, including also left axis deviation, left anterior fascicular block, incomplete and complete left bundle branch blocks, Q waves, and fragmented QRS. Importantly, the QRS complex can be within normal limits. The new paradigm stresses the electrophysiological background in interpreting QRS changes, i.e., the effect of the non-spatial determinants. This postulates that the role of ECG is not to estimate LV size in LVH, but to understand and decode the underlying electrical processes, which are crucial in relation to cardiovascular risk assessment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- ECG
- left ventricular hypertrophy
- new paradigm
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Bacharova, Ljuba
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Chevalier, Phili ...
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Gorenek, Bulent
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Jons, Christian
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Li, Yi Gang
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Locati, Emanuela ...
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visa fler...
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Maanja, Maren
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Pérez-Riera, And ...
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Platonov, Pyotr ...
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Ribeiro, Antonio ...
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Schocken, Dougla ...
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Soliman, Elsayed ...
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Svehlikova, Jana
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Tereshchenko, La ...
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Ugander, Martin
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Varma, Niraj
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Elena, Zaklyazmi ...
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Ikeda, Takanori
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
- Artiklar i publikationen
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Annals of Noninv ...
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Annals of noninv ...
- Av lärosätet
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Lunds universitet
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Karolinska Institutet