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Evaluation of Cardiac Damage in Hypertension: Electrocardiography

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Assessment of Preclinical Organ Damage in Hypertension

Abstract

The aim of this chapter is to review the literature on the use of surface electrocardiography for evaluating target-organ damage in patients with hypertension. Topics covered include a brief introduction to basic electrocardiography, pathophysiology and prognostic implications of electrocardiographic left ventricular hypertrophy, imaging surrogates and predictive value of the electrocardiographic “strain” pattern (lateral ST-T abnormalities) in hypertensive patients with and without obstructive coronary artery disease, correlates of intracardiac conduction delay (QRS duration) with risk of incident heart failure and sudden cardiac death in patients with and without concomitant left ventricular hypertrophy, clinical implications of preexisting atrial fibrillation, and novel evidence identifying new-onset atrial fibrillation as a marker of left ventricular decomenpensation in hypertension. Finally, this chapter discusses the recently proposed entity of “electrical” hypertrophy as compared to anatomical hypertrophy by echocardiogram or MRI and how this may play into the future role of classic electrocardiography as a low-cost risk-stratification tool in hypertensive patients.

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Author information

Authors and Affiliations

  1. Department of Medicine, Glostrup University Hospital, Glostrup, Copenhagen, 2600, Denmark

    Anders M. Greve MD, PhD & Kristian Wachtell MD, PhD, DMSc

  2. Division of Cardiology, Department of Medicine, Weill Cornell Medical College, 525 East 68th Street, New York, NY, 10065, USA

    Peter M. Okin MD & Kristian Wachtell MD, PhD, DMSc

  3. The Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Sønder Boulevard 29, Odense, 5000, Denmark

    Michael Hecht Olsen MD, PhD, DMSc

  4. Department of Cardiology, Örebro University Hospital, Örebro, Sweden

    Kristian Wachtell MD, PhD, DMSc

Authors
  1. Anders M. Greve MD, PhD
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  2. Peter M. Okin MD
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  3. Michael Hecht Olsen MD, PhD, DMSc
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  4. Kristian Wachtell MD, PhD, DMSc
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Corresponding author

Correspondence to Anders M. Greve MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

    Enrico Agabiti Rosei

  2. IRCCS Istituto Auxologico Italiano, University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia

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Greve, A.M., Okin, P.M., Olsen, M.H., Wachtell, K. (2015). Evaluation of Cardiac Damage in Hypertension: Electrocardiography. In: Agabiti Rosei, E., Mancia, G. (eds) Assessment of Preclinical Organ Damage in Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-15603-3_1

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  • DOI: https://doi.org/10.1007/978-3-319-15603-3_1

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15602-6

  • Online ISBN: 978-3-319-15603-3

  • eBook Packages: MedicineMedicine (R0)

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