Left ventricular hypertrophyLVH

Left ventricular hypertrophy (LVH) is an increase in the muscle mass and wall thickness of the left ventricle, the heart's main pumping chamber. It is usually an adaptation to the heart having to work harder over a long period, most often against raised blood pressure.

It matters because, unlike the benign heart changes seen in trained endurance athletes, the LVH driven by chronic high blood pressure is associated with a higher risk of heart failure, abnormal heart rhythms and cardiovascular events. It is a marker that the cardiovascular system has been under sustained strain.

In practice it is screened for with an ECG and confirmed and measured with an echocardiogram (a heart ultrasound). ECG voltage criteria are convenient but imperfect, and thresholds that work in one population do not always transfer to another, so results are read alongside blood pressure and overall cardiovascular risk.