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AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinic
| Content Provider | Semantic Scholar |
|---|---|
| Author | Hancock, E. William Deal, Barbara J. Mirvis, David M. Okin, Peter Kligfield, Paul Gettes, Leonard S. Bailey, James J. Childers, Rory Gorgels, Anton P. M. Josephson, Mark Kors, Jan A. Macfarlane, Peter Mason, J. Wright Pahlm, Olle Rautaharju, Pentti M. Surawicz, Borys Herpen, Gerard Van Wagner, Galen S. Wellens, Hein J. J. |
| Copyright Year | 2009 |
| Abstract | The detection and assessment of cardiac chamber hypertrophy has long been an important objective of clinical electrocardiography. Its importance has increased in recent years with the recognition that hypertrophy can be reversed with therapy, and that by doing so, adverse clinical outcomes can be prevented or delayed.1,2 (Note: This report uses the term hypertrophy rather than enlargement . The 1978 Bethesda Conference favored use of the term enlargement, but hypertrophy is more commonly used in recent research reports, although not necessarily in textbooks. Enlargement may be taken to imply an increase in chamber dimension, which may not be present in concentric hypertrophy. It is doubtful whether enlargement occurs without hypertrophy, at least in chronic stable syndromes. As discussed below, distinctive P-wave abnormalities may occur in the absence of atrial hypertrophy or dilation.) The principal electrocardiogram (ECG) changes associated with ventricular hypertrophy are increases in QRS amplitude and duration, changes in instantaneous and mean QRS vectors, abnormalities in the ST segment and T waves, and abnormalities in the P wave. These changes have been correlated with direct or indirect assessments of ventricular size or mass to establish electrocardiographic criteria for the diagnosis of hypertrophy. Originally, measurement of ventricular mass at autopsy or the clinical features of the patients were the reference standards used to establish ECG criteria. Later, the ECG changes were referenced against findings from various imaging modalities such as chest radiography or left ventriculography. In recent years, 2-dimensional echocardiography has become the favored reference standard, but it is now being challenged by 3-dimensional echocardiography, computerized tomography, and magnetic resonance imaging.3 Although these newer imaging techniques provide a more accurate assessment of ventricular myocardial mass than does the ECG, they do not obviate the clinical use of the ECG. The greater convenience and lower cost of the ECG … |
| Starting Page | 992 |
| Ending Page | 1002 |
| Page Count | 11 |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.jacc.2008.12.015 |
| PubMed reference number | 19281932 |
| Journal | Medline |
| Volume Number | 53 |
| Issue Number | 11 |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/119/10/e251.full.pdf?download=true |
| Alternate Webpage(s) | https://doi.org/10.1016/j.jacc.2008.12.015 |
| Journal | Journal of the American College of Cardiology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
