Kannel W B, Dannenberg A L, Levy D
Evans Department of Clinical Research, University Hospital, Boston, Massachusetts 02118.
Am J Cardiol. 1987 Dec 14;60(17):85I-93I. doi: 10.1016/0002-9149(87)90466-8.
Left ventricular (LV) hypertrophy on the electrocardiogram is an ominous harbinger of cardiovascular disease in the general population markedly increasing the risk of coronary heart disease, cardiac failure, stroke and peripheral arterial disease. This contribution to risk exceeds that of the often accompanying hypertension. Once overt coronary disease occurs, electrocardiographic LV hypertrophy also further escalates risk of cardiovascular morbidity and mortality. The risk associated with electrocardiographic LV hypertrophy is particularly great when repolarization abnormality is present. Electrocardiographic LV hypertrophy and silent electrocardiographic myocardial infarction are similar in evolution and prognosis. LV hypertrophy is an important predictor of risk of cardiac failure; the electrocardiographic manifestation of LV hypertrophy predisposes to cardiac failure more than x-ray cardiac enlargement. Electrocardiographic LV hypertrophy heralds the onset of serious cardiovascular disease and premature mortality despite lack of associated symptoms. The serious prognosis of this abnormality warrants vigorous preventive management. More prospective data are needed comparing the prognosis of echocardiographic anatomical hypertrophy with that diagnosed by electrocardiography.
心电图显示的左心室（LV）肥厚是普通人群心血管疾病的不祥预兆，会显著增加冠心病、心力衰竭、中风和外周动脉疾病的风险。这种对风险的影响超过了常伴随的高血压。一旦发生明显的冠心病，心电图左心室肥厚也会进一步增加心血管发病和死亡风险。当存在复极异常时，与心电图左心室肥厚相关的风险尤其大。心电图左心室肥厚和无症状心电图心肌梗死在演变和预后方面相似。左心室肥厚是心力衰竭风险的重要预测指标；心电图左心室肥厚比X线心脏扩大更容易引发心力衰竭。尽管没有相关症状，心电图左心室肥厚预示着严重心血管疾病的发生和过早死亡。这种异常的严重预后需要积极的预防性管理。需要更多前瞻性数据来比较超声心动图解剖学肥厚与心电图诊断的肥厚的预后。
