[Left ventricular hypertrophy : how to identity the cause ?]

Left ventricular hypertrophy (LVH) is defined by an increase in left ventricular mass. LVH can be adaptive and related to an increase in left ventricular pressure or volume load, or can be related to a primary myocardial disease including sarcomeric, inflammatory or infiltrative disorders. The prevalence of left ventricular hypertrophy increases with age, and its presence is a risk factor for cardiovascular events and death. Recognizing the exact condition underlying LVH is a key step to provide an optimal medical management of those patients, including risk stratification, prognosis and treatment. By the use of multimodal imaging, by the appropriate use of genetics, and by considering clinical, electrical and biological red flags, the identification of the underlying disease becomes more and more achievable in the clinics, without the need for a myocardial biopsy. This review describes the recent diagnostic advances for the medical management of left ventricular hypertrophy.