Electrocardiographic Diagnosis of Right Ventricular Hypertrophy: a Literature Review

Abstract

The development of right ventricular hypertrophy (RVH) is a consequence of a large group of diseases that lead to increased pressure or volume load on the right ventricle. Electrocardiography (ECG) is a commonly used diagnostic method in clinical practice. This method allows for the identification of RVH signs in the early stages of examination. During the 20th century, more than 30 diagnostic criteria were developed. Several of these criteria are associated with worse prognosis, including increased mortality. Authors of international guidelines recommend the verification of criteria in local populations. Such studies have not been published in Russia, but according to data obtained from foreign researchers, the diagnostic properties of ECG criteria can vary significantly. In most cases, the criteria are characterized by low sensitivity and high specificity, which complicates early diagnosis of conditions leading to RVH development. It is proposed to increase the sensitivity of the method by using all the developed criteria or sets that include some of them. However, this approach may reduce the specificity of ECG diagnosis of RVH, and the selection of criteria for inclusion in diagnostic algorithms is not always based on scientific research data. This article analyzes the history of the development of RVH criteria, research data on their diagnostic capabilities, and ways to improve diagnostic algorithms.