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MULTIMODALITY IMAGING FOR LEFT VENTRICULAR HYPERTROPHY SEVERITY GRADING: A METHODOLOGICAL REVIEW
Maaike Alkema2,1, Ernest Spitzer2,3*, Osama I.I. Soliman2,3, Christian Loewe4
1Leiden University Medical Center
2Cardialysis Core Laboratories & Clinical Trial Management
3Thoraxcenter, Erasmus University Medical Center
4Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna
Corresponding Author: Ernest Spitzer ,Email: ernest.spitzer@gmail.com
ABSTRACT
Left ventricular hypertrophy (LVH), defined by an increase in left ventricular myocardial mass (LVM), is a common cardiac finding generally caused by an increase in pressure or volume load. Assessing severity of LVH is of great clinical value in terms of prognosis and treatment choices, as LVH severity grades correlate with the risk for presenting cardiovascular events. The three main cardiac parameters for the assessment of LVH are wall thickness, LVM, and LV geometry. Echocardiography, with large availability and low cost, is the technique of choice for their assessment. Consequently, reference values for LVH severity in clinical guidelines are based on this technique. However, cardiac magnetic resonance (CMR) and computed tomography (CT) are increasingly used in clinical practice, providing excellent image quality. Nevertheless, there is no extensive data to support reference values based on these techniques, while comparative studies between the three techniques show different results in wall thickness and LVM measurements. In this paper, we provide an overview of the different methodologies used to assess LVH severity with echocardiography, CMR and CT. We argue that establishing reference values per imaging modality, and possibly indexed to body surface area and classified per gender, ethnicity and age-group, might be essential for the correct classification of LVH severity.
Keywords: Hypertrophy, left ventricular, Echocardiography, Magnetic Resonance Imaging, Multidetector Computed Tomography
Volume 25, No 3
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