Echocardiographic differentiation of pathological and physiological left ventricular hypertrophy.

Left ventricular hypertrophy is a serious condition, strongly associated with the development of coronary artery disease, cerebrovascular disease, cardiac failure, sudden cardiac death, and overall mortality. In addition, regression of left ventricular hypertrophy is associated with reduction in all cause and cardiovascular mortality. The existence, therefore, of left ventricular hypertrophy in apparently healthy people has generated considerable interest ever since its initial description. Debate has centred on two major issues. The first concerns the nature of left ventricular hypertrophy of athleticism: is it simply a physiological response to periodic myocardial loading or does it have a pathological component and therefore carry implications for long term prognosis? The second concerns the diagnosis of left ventricular hypertrophy of athleticism: is it possible to diVerentiate with confidence physiological left ventricular hypertrophy from pathological conditions?