Editing Left ventricular hypertrophy (section)

===ECG criteria===
[[File:Left ventricular hypertrophy with secondary repolarization.jpg|thumb|300px|Left ventricular hypertrophy with secondary repolarization abnormalities as seen on ECG]]
[[File:Histopathology of myocardial hypertrophy.jpg|thumb|[[Histopathology]] of (a) normal myocardium and (b) myocardial hypertrophy. Scale bar indicates 50 μm.]]
[[File:Gross pathology of left ventricular hypertrophy.jpg|thumb|[[Gross pathology]] of left ventricular hypertrophy. Left ventricle is at right in image, serially sectioned from apex to near base.]]
There are several sets of criteria used to diagnose LVH via electrocardiography.<ref name="urlLesson VIII - Ventricular Hypertrophy">{{cite web |url=http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson8/index.html#LVH |title=Lesson VIII - Ventricular Hypertrophy |access-date=2009-01-07}}</ref>  None of them are perfect, though by using multiple criteria sets, the [[sensitivity (tests)|sensitivity]] and [[Specificity (tests)|specificity]] are increased.

The '''Sokolow-Lyon index''':<ref>{{cite journal | vauthors = Sokolow M, Lyon TP | title = The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads | journal = American Heart Journal | volume = 37 | issue = 2 | pages = 161–186 | date = February 1949 | pmid = 18107386 | doi = 10.1016/0002-8703(49)90562-1 }}</ref><ref name="Time-Voltage QRS Area of the 12-Lead Electrocardiogram : Detection of Left Ventricular Hypertrophy -- Okin et al. 31 (4): 937 -- Hypertension">{{cite journal | vauthors = Okin PM, Roman MJ, Devereux RB, Pickering TG, Borer JS, Kligfield P | title = Time-voltage QRS area of the 12-lead electrocardiogram: detection of left ventricular hypertrophy | journal = Hypertension | volume = 31 | issue = 4 | pages = 937–942 | date = April 1998 | pmid = 9535418 | doi = 10.1161/01.HYP.31.4.937 | s2cid = 2662286 | citeseerx = 10.1.1.503.8356 }}</ref>
* S in V<sub>1</sub> + R in V<sub>5</sub> or V<sub>6</sub> (whichever is larger) ≥ 35&nbsp;mm (≥ 7 large squares)
* R in aVL ≥ 11&nbsp;mm

The '''Cornell voltage criteria'''<ref>{{cite journal | vauthors = Casale PN, Devereux RB, Alonso DR, Campo E, Kligfield P | title = Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings | journal = Circulation | volume = 75 | issue = 3 | pages = 565–572 | date = March 1987 | pmid = 2949887 | doi = 10.1161/01.CIR.75.3.565 | s2cid = 25815927 | doi-access =  }}</ref> for the ECG diagnosis of LVH involve measurement of the sum of the R wave in lead aVL and the S wave in lead V<sub>3</sub>.  The Cornell criteria for LVH are:
* S in V<sub>3</sub> + R in aVL > 28&nbsp;mm (men)
* S in V<sub>3</sub> + R in aVL > 20&nbsp;mm (women)

The '''Romhilt-Estes point score system''' ("diagnostic" >5 points; "probable" 4 points):

{|
||ECG Criteria||Points
|-
||Voltage Criteria (any of):
# R or S in limb leads ≥20&nbsp;mm
# S in V<sub>1</sub> or V<sub>2</sub> ≥30&nbsp;mm
# R in V<sub>5</sub> or V<sub>6</sub> ≥30&nbsp;mm
||3
|-
||ST-T Abnormalities:
* ST-T vector opposite to QRS without digitalis
* ST-T vector opposite to QRS with digitalis
||
3<br />
1
|-
||Negative terminal P mode in V<sub>1</sub> 1&nbsp;mm in depth and 0.04 sec in duration (indicates [[left atrial enlargement]])
||3
|-
||Left axis deviation (QRS of −30° or more)
||2
|-
||QRS duration ≥0.09 sec
||1
|-
||Delayed [[intrinsicoid deflection]] in V<sub>5</sub> or V<sub>6</sub> (>0.05 sec)
||1
|}

Other voltage-based criteria for LVH include:
* Lead I: R wave > 14&nbsp;mm
* Lead aVR: S wave > 15&nbsp;mm
* Lead aVL: R wave > 12&nbsp;mm
* Lead aVF: R wave > 21&nbsp;mm
* Lead V<sub>5</sub>: R wave > 26&nbsp;mm
* Lead V<sub>6</sub>: R wave > 20&nbsp;mm

Diagnostic accuracy of electrocardiography in left ventricular hypertrophy can be enhanced with [[artificial intelligence]] analysis.<ref>{{cite journal |last1=Martínez-Sellés |first1=Manuel |last2=Marina-Breysse |first2=Manuel |title=Current and Future Use of Artificial Intelligence in Electrocardiography |journal=Journal of Cardiovascular Development and Disease |date=2023 |volume=10 |issue=4 |page=175 |doi=10.3390/jcdd10040175 |doi-access=free |pmid=37103054 |pmc=10145690 }}</ref>