ELECTROCARDIOGRAPHIC DIAGNOSIS OF LEFT VENTRICULAR MYOCARDIAL HYPERTROPHY (LITERATURE REVIEW)

Abstract

Left ventricular hypertrophy (LVH) is one of the most important predictors of cardiovascular events in patients with arterial hypertension (AH). Literature data on the role of electrocardiography (ECG) in diagnosing left ventricular (LV) myocardial hypertrophy are presented. Recommendations of the European Society of Cardiology and the European Society of Hypertension from 2018 and International Clinical Protocols "Duodecim" state the following LVH criteria: Sokolov-Lyon criteria: SV1 + RV5 > 35 mm; wave R in lead aVL > 11 mm; SV1 ≥ 25 mm, RV5–V6 > 25 mm; Cornell voltage index: SV3 + RaVL >20 mm in women and >28 mm in men; Cornell product: the product of the Cornell voltage index and the duration of the QRS complex (RaVL + SV3) × QRS – for men and (RaVL + SV3 + 8) × QRS – for women. The criteria of LVH is the value of the Cornell product > 2440 mm×ms. However, ECG criteria for detecting LVH are not sensitive enough. Peguero JG, Lo Presti S, et al. (2017) developed a more accurate method of diagnosing LVH by measuring the amplitude of the deepest S wave (SD) in any individual lead and adding it to the amplitude of the S wave in lead V4 (SV4) [SD+ SV4]. When the sum of [SD+ SV4] exceeds 28 mm in men or 23 mm in women (Peguero-Lo Presti criteria), LVH can be diagnosed.Objective: to systematize modern literary data on electrocardiographic diagnosis of left ventricular myocardial hypertrophy. Conclusion. Due to its low cost, easy availability, reproducibility and high specificity, electrocardiography remains the simplest and most common method of diagnosing myocardial hypertrophy. The Peguero-Lo Presti criteria for diagnosing left ventricular hypertrophy are more sensitive and specific than the voltage criteria of Sokolov-Lyon and Cornell.