WordNet

toward or on the left; also used figuratively; "he looked right and left"; "the political party has moved left"
a turn toward the side of the body that is on the north when the person is facing east; "take a left at the corner"
the hand that is on the left side of the body; "jab with your left" (同)left_hand
those who support varying degrees of social or political or economic change designed to promote the public welfare (同)left wing
location near or direction toward the left side; i.e. the side to the north when a person or object faces east; "she stood on the left"
intended for the left hand; "I rarely lose a left-hand glove" (同)left-hand
being or located on or directed toward the side of the body to the west when facing north; "my left hand"; "left center field"; "the left bank of a river is bank on your left side when you are facing downstream"
of or belonging to the political or intellectual left
abnormal enlargement of a body part or organ
undergo hypertrophy; "muscles can hypertrophy when people take steroids"
of or relating to a ventricle (of the heart or brain)

PrepTutorEJDIC

leaveの過去・過去分詞
《名詞の前にのみ用いて》『左の』,左方の / 《しばしばl-》(政治上の)左翼の,左派の,革新派の / 左に,左方に / 《通例 the ~》『左』,左方,左側 / 《しばしばthe L-》左翼の政党(団体),左派 / 〈U〉(野球で)左翼,レフト(left field);〈C〉左翼手(left fielder) / 〈C〉(ボクシングで)左手打ち
(生物体の部分・器官の)異常肥大,異常発達

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/10/31 06:10:05」(JST)

wiki en

Left ventricular hypertrophy (LVH) is the thickening of the myocardium (muscle) of the left ventricle of the heart.

Causes

While ventricular hypertrophy occurs naturally as a reaction to aerobic exercise and strength training, it is most frequently referred to as a pathological reaction to cardiovascular disease, or high blood pressure.^[1]

While LVH itself is not a disease, it is usually a marker for disease involving the heart.^[2] Disease processes that can cause LVH include any disease that increases the afterload that the heart has to contract against, and some primary diseases of the muscle of the heart.

Causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency and hypertension. Primary disease of the muscle of the heart that cause LVH are known as hypertrophic cardiomyopathies, which can lead into heart failure.

Long-standing mitral insufficiency also leads to LVH as a compensatory mechanism.

Diagnosis

The principal method to diagnose LVH is echocardiography, with which the thickness of the muscle of the heart can be measured. The electrocardiogram (ECG) often shows signs of increased voltage from the heart in individuals with LVH, so this is often used as a screening test to determine who should undergo further testing.

Echocardiography

Two dimensional echocardiography can produce images of the left ventricle. The thickness of the left ventricle as visualized on echocardiography correlates with its actual mass. Normal thickness of the left ventricular myocardium is from 0.6 to 1.1 cm (as measured at the very end of diastole. If the myocardium is more than 1.1 cm thick, the diagnosis of LVH can be made.

ECG criteria for LVH

There are several sets of criteria used to diagnose LVH via electrocardiography.^[3] None of them is perfect, though by using multiple criteria sets, the sensitivity and specificity are increased.

The Sokolow-Lyon index:^[4]^[5]

S in V₁ + R in V₅ or V₆ (whichever is larger) ≥ 35 mm (≥ 7 large squares)
R in aVL ≥ 11 mm

The Cornell voltage criteria^[6] for the ECG diagnosis of LVH involve measurement of the sum of the R wave in lead aVL and the S wave in lead V₃. The Cornell criteria for LVH are:

S in V₃ + R in aVL > 28 mm (men)
S in V₃ + R in aVL > 20 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 mm S in V₁ or V₂ ≥30 mm R in V₅ or V₆ ≥30 mm	3
ST-T Abnormalities: ST-T vector opposite to QRS without digitalis ST-T vector opposite to QRS with digitalis	3 1
Negative terminal P mode in V₁ 1 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 V₅ or V₆ (>0.05 sec)	1

Other voltage-based criteria for LVH include:

Lead I: R wave > 14 mm
Lead aVR: S wave > 15 mm
Lead aVL: R wave > 12 mm
Lead aVF: R wave > 21 mm

Lead V₅: R wave > 26 mm
Lead V₆: R wave > 20 mm

Treatment

The enlargement is not permanent in all cases, and in some cases the growth can regress with the reduction of blood pressure and controlling excitements/emotions strictly.^[7]

LVH may be a factor in determining treatment or diagnosis for other conditions. For example, LVH causes a patient to have an irregular ECG. Patients with LVH may have to participate in more complicated and precise diagnostic procedures, such as imaging, in situations in which a physician could otherwise give advice based on an ECG.^[8]^[9]

Associated genes

OGN, osteoglycin

References

^ "Ask the doctor: Left Ventricular Hypertrophy". Retrieved 2007-12-07.
^ Meijs MF, Bots ML, Vonken EJ, et al. (2007). "Rationale and design of the SMART Heart study: A prediction model for left ventricular hypertrophy in hypertension". Neth Heart J 15 (9): 295–8. doi:10.1007/BF03086003. PMC 1995099. PMID 18030317.
^ "Lesson VIII - Ventricular Hypertrophy". Retrieved 2009-01-07.
^ Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949;37:161–186.
^ "Time-Voltage QRS Area of the 12-Lead Electrocardiogram : Detection of Left Ventricular Hypertrophy -- Okin et al. 31 (4): 937 -- Hypertension". Retrieved 2007-12-07.
^ Casale PN, Devereux RB, Alonso DR, Campo E, Kligfield P (1987). "Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings". Circulation 75 (3): 565–72. doi:10.1161/01.CIR.75.3.565. PMID 2949887.
^ Gradman AH, Alfayoumi F (2006). "From left ventricular hypertrophy to congestive heart failure: management of hypertensive heart disease". Prog Cardiovasc Dis 48 (5): 326–41. doi:10.1016/j.pcad.2006.02.001. PMID 16627048.
^ American Society of Nuclear Cardiology, Five Things Physicians and Patients Should Question, Choosing Wisely: an initiative of the ABIM Foundation (American Society of Nuclear Cardiology), retrieved August 17, 2012
^ Anderson, J. L.; Adams, C. D.; Antman, E. M.; Bridges, C. R.; Califf, R. M.; Casey, D. E.; Chavey, W. E.; Fesmire, F. M.; Hochman, J. S.; Levin, T. N.; Lincoff, A. M.; Peterson, E. D.; Theroux, P.; Wenger, N. K.; Wright, R. S. (2007). "ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction): Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine". Circulation 116 (7): 803. doi:10.1161/CIRCULATIONAHA.107.185752. edit

UpToDate Contents

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1. 左室肥大の心電図による診断 electrocardiographic diagnosis of left ventricular hypertrophy
2. 高血圧における左室肥大の臨床的意義および治療 clinical implications and treatment of left ventricular hypertrophy in hypertension
3. 左室肥大および不整脈 left ventricular hypertrophy and arrhythmia
4. 高血圧における左室肥大の定義および病因 definition and pathogenesis of left ventricular hypertrophy in hypertension
5. 慢性腎疾患における貧血および左室肥大 anemia and left ventricular hypertrophy in chronic kidney disease

English Journal

Aldosterone induces electrical remodeling independent of hypertension.

Dartsch T, Fischer R, Gapelyuk A, Weiergraeber M, Ladage D, Schneider T, Schirdewan A, Reuter H, Mueller-Ehmsen J, Zobel C.SourceDepartment of Internal Medicine III, University of Cologne, Cologne, Germany.
International journal of cardiology.Int J Cardiol.2013 Apr 5;164(2):170-8. doi: 10.1016/j.ijcard.2011.06.100. Epub 2011 Jul 18.
BACKGROUND: Treatment of heart failure patients with aldosterone antagonists has been shown to reduce the occurrence of sudden cardiac death. Therefore we aimed at determining the consequences of chronic exposure to aldosterone and the aldosterone antagonists eplerenone and spironolactone on the ele
PMID 21764470

Mitral Annular Calcification and Incident Ischemic Stroke in Treated Hypertensive Patients: The LIFE study.

De Marco M, Gerdts E, Casalnuovo G, Migliore T, Wachtell K, Boman K, Dahlöf B, Olsen MH, Kizer JR, Devereux RB, de Simone G.SourceDepartment of Translational Medical Sciences, Federico II University Hospital, Napoli, Italy;
American journal of hypertension.Am J Hypertens.2013 Apr;26(4):567-73. doi: 10.1093/ajh/hps082. Epub 2013 Feb 7.
Background Fibro-calcification of the mitral annulus (MAC) has been associated with increased risk of ischemic stroke in general populations. This study was performed to assess whether MAC predicts incidence of ischemic stroke in treated hypertensive patients with left ventricular hypertrophy (LVH).
PMID 23391619

Prevalence of echocardiographic left-atrial enlargement in hypertension: a systematic review of recent clinical studies.

Cuspidi C, Rescaldani M, Sala C.SourceDepartment of Health Science, University of Milano-Bicocca, Milan, Italy;
American journal of hypertension.Am J Hypertens.2013 Apr;26(4):456-64. doi: 10.1093/ajh/hpt001. Epub 2013 Feb 6.
BACKGROUND Left atrial enlargement (LAE) is a marker of hypertensive heart disease associated with increased cardiovascular risk. We reviewed recent literature about the prevalence of LAE, as assessed by echocardiography, to update our information about the clinical relevance of this cardiac phenoty
PMID 23388831

Japanese Journal

心房細動発症と高血圧治療 (特集心房細動 : 診断・治療の最新動向) -- (特論)

大蔵隆文,檜垣實男
日本臨床 71(1), 167-173, 2013-01
NAID 40019536623

心機能の著明な改善が得られた生体腎移植の1例

三井要造,安食春輝,井上圭太 [他]
西日本泌尿器科 = The Nishinihon journal of urology 74(11), 623-627, 2012-11
NAID 40019487417

糖尿病性心筋障害の臨床的特徴と画像診断

百瀬満
循環器内科 72(4), 448-454, 2012-10
NAID 40019474304

Related Pictures

★リンクテーブル★

リンク元	「左室肥大」「LVH」
関連記事	「ventricular」「left」「left ventricular」

「左室肥大」

Left ventricular hypertrophy
	Classification and external resources
	A heart with left ventricular hypertrophy in short-axis view
ICD-10	I51.7
ICD-9	429.3
DiseasesDB	7659
MeSH	D017379