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Left Ventricular Hypertrophy: The Relationship between the Electrocardiogram and Cardiovascular Magnetic Resonance Imaging.
[fabry disease]
Conventional
assessment
of
left
ventricular
hypertrophy
(
LVH
)
using
the
electrocardiogram
(
ECG
)
,
for
example
,
by
the
Sokolow-
Lyon
,
Romhilt-
Estes
or
Cornell
criteria
,
have
relied
on
assessing
changes
in
the
amplitude
and
/
or
duration
of
the
QRS
complex
of
the
ECG
to
quantify
LV
mass
.
ECG
measures
of
LV
mass
have
typically
been
validated
by
imaging
with
echocardiography
or
cardiovascular
magnetic
resonance
imaging
(
CMR
)
.
However
,
LVH
can
be
the
result
of
diverse
etiologies
,
and
LVH
is
also
characterized
by
pathological
changes
in
myocardial
tissue
characteristics
on
the
genetic
,
molecular
,
cellular
,
and
tissue
level
beyond
a
pure
increase
in
the
number
of
otherwise
normal
cardiomyocytes
.
For
example
,
slowed
conduction
velocity
through
the
myocardium
,
which
can
be
due
to
diffuse
myocardial
fibrosis
,
has
been
shown
to
be
an
important
determinant
of
conventional
ECG
LVH
criteria
regardless
of
LV
mass
.
Myocardial
tissue
characterization
by
CMR
has
emerged
to
not
only
quantify
LV
mass
,
but
also
detect
and
quantify
the
extent
and
severity
of
focal
or
diffuse
myocardial
fibrosis
,
edema
,
inflammation
,
myocarditis
,
fatty
replacement
,
myocardial
disarray
,
and
myocardial
deposition
of
amyloid
proteins
(
amyloidosis
)
,
glycolipids
(
Fabry
disease
)
,
or
iron
(
siderosis
)
.
This
can
be
undertaken
using
CMR
techniques
including
late
gadolinium
enhancement
(
LGE
)
,
T
1
mapping
,
T
2
mapping
,
T
2
*
mapping
,
extracellular
volume
fraction
(
ECV
)
mapping
,
fat
/
water-weighted
imaging
,
and
diffusion
tensor
CMR
.
This
review
presents
an
overview
of
current
and
emerging
concepts
regarding
the
diagnostic
possibilities
of
both
ECG
and
CMR
for
LVH
in
an
attempt
to
narrow
gaps
in
our
knowledge
regarding
the
ECG
diagnosis
of
LVH
.
Diseases
Validation
Diseases presenting
"diffuse myocardial fibrosis"
symptom
fabry disease
systemic capillary leak syndrome
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