AUTHOR=Barbieri Andrea , Albini Alessandro , Maisano Anna , De Mitri Gerardo , Camaioni Giovanni , Bonini Niccolò , Mantovani Francesca , Boriani Giuseppe 

TITLE=Clinical Value of Complex Echocardiographic Left Ventricular Hypertrophy Classification Based on Concentricity, Mass, and Volume Quantification

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.667984

DOI=10.3389/fcvm.2021.667984

ISSN=2297-055X

ABSTRACT=Echocardiography is the noninvasive, most validated, and used approach to assessing left ventricular hypertrophy (LVH). Alternative methods, specifically magnetic resonance imaging, providing high cost and practical challenges in large scale clinical application. However, to include a wide range of physiological and pathological conditions, LVH should be considered in conjunction with the LV remodeling assessment. The universally known 2-group classification of LVH considers the only estimation of LV mass and relative wall thickness (RWT) to be classifying variables. However, the knowledge of the 2-tiered patterns provided particularly limited incremental prognostic information beyond LVH. Conversely, LV enlargement conveyed independent prognostic utility beyond LV mass for incident heart failure. Therefore, a 4-group LVH subdivision based on LV mass, LV volume, and RWT has recently been suggested. This novel classification of LVH is characterized by distinct differences in cardiac function, allowing clinicians to distinguish between different LV hemodynamic stress adaptations in various cardiovascular diseases. Thus, the new 4-group LVH classification has the advantage of optimizing the LVH diagnostic approach and the potential to improve the identification of maladaptive responses that warrant targeted therapy. In this review, we summarize the current knowledge on the clinical value of this refinement of the LVH classification, emphasizing the role of echocardiography in applying contemporary proposed indexation methods and partition values.