title: Electrocardiographic left ventricular hypertrophy with strain pattern: prevalence, mechanisms and prognostic implications.
abstract: BACKGROUND
  Electrocardiographic left ventricular hypertrophy with strain pattern has been documented as a marker for left ventricular hypertrophy. Its presence on the ECG of hypertensive patients is associated with a poor prognosis. This review was undertaken to report the prevalence, mechanism and prognostic implications of this ECG abnormality.
  
  
  METHODS
  We conducted a comprehensive search of electronic databases to identify studies relating to the title of this review. The search criteria were related to the title. Two of the reviewers independently screened the searches.
  
  
  RESULTS
  Results were described qualitatively. The data were not pooled because there were no randomised studies on the topic. The prevalence of ECG strain pattern ranged from 2.1 to 36%. The highest prevalence was reported before the era of good antihypertensive therapy. The sensitivity as a measure of left ventricular hypertrophy ranged from 3.8 to 50%, while the specificity was in the range of 89.8 to 100%. Strain pattern was associated with adverse cardiovascular risk factors as well as increased all-cause and CV morbidity and mortality. ST-segment depression and T-wave inversion on the ECG was recognised as the strongest marker of morbidity and mortality when ECG-LVH criteria were utilised for risk stratification in hypertensive subjects.
  
  
  CONCLUSIONS
  Electrocardiographic strain pattern identifies cardiac patients at higher risk of cardiovascular-related as well as all-cause morbidity and mortality.
authors.affiliation: Department of Medicine, Federal Medical Centre, Idi-Aba, Abeokuta, Ogun State, Nigeria.
authors.forename: O S
authors.initials: OS
authors.lastname: Ogah
authors.forename: O O
authors.initials: OO
authors.lastname: Oladapo
authors.forename: A A
authors.initials: AA
authors.lastname: Adebiyi
authors.forename: A K
authors.initials: AK
authors.lastname: Adebayo
authors.forename: A
authors.initials: A
authors.lastname: Aje
authors.forename: D B
authors.initials: DB
authors.lastname: Ojji
authors.forename: B L
authors.initials: BL
authors.lastname: Salako
authors.forename: A O
authors.initials: AO
authors.lastname: Falase
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004562:Electrocardiography; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors