Method	Diagnosis criteria	Source
Electrocardiogram	Romhilt‐Estes Point Score SCORE ESTES: 4 point: probable LVH ≥ 5 point: LVH diagnosed Voltage criteria = 3 points ST‐T abnormalities without digital = 3, with digital = 1 Electrical axis deviation > ‐15 degrees = 2 QRS duration > 0.09 second = 1 Intrinsicoid deflection > 0.04 second = 1 SCORE ROMHILT: 4 point: probable LVH ≥ 5 point: LVH diagnosed Amplitude of R or S in limb leads > 2 mV or S in V1 or V2 > 3 mV or R in V5 or V6 > 3 mV = 3 points ST segment changes with or without digital = 1 or 2 points, respectively Left atrial enlargement = 3 points Left axis deviation > 30 degrees = 2 points QRS duration > 0.09 second and intrinsicoid deflection in V5 and V6 > 0.05 = 1 point each ROMHILT‐ESTES POINT SCORE: 4 point: probable LVH ≥ 5 point: LVH diagnosed Voltage criteria (3 points): Any S or R in limb leads ≥ 20 mm SV1, SV2, RV5, or RV6 ≥ 30 mm ST‐T wave changes of LVH (3 points, 1 point on digitalis) Left atrial abnormality (3 points): Terminal component of the P wave in V1 ≥ 1 mm and ≥ 40 ms Left axis deviation (2 points): QRS axis of –30 degrees or more negative Prolonged QRS duration (1 point): ≥ 90 ms Delayed intrinsicoid deflection time (1 point): ≥ 50 ms in V5 or V6	Romhilt 1968 Ang 2008 Giuliani 1996 Fisch 1993 Bauml 2010
	Sokolow‐Lyon criteria SV1 + RV5‐V6 ≥ 3.5 mV or max RV5/6 ≥ 2.6 mV	Ang 2008
	McPhie The sum of the tallest R and deepest S in the precordial leads > 45 mm	Ang 2008
	The sum of 12‐lead QRS voltages Sum of max (R + S) amplitude in each of the 12 leads > 179 mm	Ang 2008
	Minnesota code R AVL > 7 mm R V5 or V6 plus S V1 or V2 > 35 mm R V6 > R V4 R V6 > R V5 S V2 > 24 mm R D1 plus S D3 > 25 mm RV5/V6 > 2.6 mV, RI/II/III/aVF > 2.0 mV or RaVL > 1.2 mV	Malmqvist 2001 Ang 2008
	Cornell voltage criteria SV3 + RV1 ≥ 20 mm in women or SV3 + RV1 ≥ 28 mm in men	González‐Juanatey 2007
	Manning R DI > 13 mm	Romhilt 1969
	Mazzoleni R aVL > 7.5 mm	Romhilt 1969
	Cornell Product (RaVL + SV3) x QRS duration ≥ 2436 mm/ms	Ang 2008
	Lewis Index (RI + SIII) ‐ (RIII + SI) > 1.7 mV	Ang 2008
	Gubner‐Ungerleider RI + SIII ≥ 2.2 mV	Ang 2008
	Simonson Simonson studies as the upper limits of normal (97.5 percentile) for the R‐wave amplitude of 20 mm are any standard lead of 25 mm in precordial V5 and 44 mm for the amount of S in V1 and R in V5. Above these values is considered LVH	Ang 2008
	Perugia Score Positivity of at least 1 of the following: SV3 + RaVL > 2.4 mV Left ventricular strain pattern Romhilt–Estes point score ≥ 5	Ang 2008
	Framingham Score RI + SIII > 2.5 mV, SV1/2 + RV5/6 > 3.5mV, SV1/2/3 > 2.5 mV + RV4/5/6 > 2.5 mV plus left ventricular strain pattern	Ang 2008
Echocardiogram	American Society of Echocardiography criteria Normal values: relative wall thickness ≤ 0.42, left ventricular mass index (g/m2) ≤ 95 and ≤ 115, according to female or male, respectively. In function of left ventricular mass index and relative wall thickness normal values, 3 patterns of LVH are possible: Concentric remodeling: when relative wall thickness is increased with normal left ventricular mass index. Concentric hypertrophy: when relative wall thickness and left ventricular mass index are increased. The ratio of ventricular wall thickness to radius (relative wall thickness) is increased and refers to a ventricle with thick walls relative to cavity volume. Eccentric hypertrophy (or volume‐overload): When relative wall thickness is normal, and left ventricular mass index is increased. The ratio is decreased and refers to a ventricle with an expanded cavitary volume in proportion to wall thickness.	Lang 2005
	Simpson criteria American Society of Echocardiography with the European Association of Echocardiography has issued the following criteria for LVH using modified Simpson's rule: Estimated left ventricular mass of 201 to 227 g (103 to 116 g/m2) for men and 151 to 171 g (89 to 100 g/m2) for women is mildly abnormal. Estimated left ventricular mass of 228 to 254 g (117 to 130 g/m2) for men and 172 to 182 g (101 to 112 g/m2) for women is moderately abnormal. Estimated left ventricular mass > 255 g (> 131 g/m2) for men and > 193 g (> 113 g/m2) for women is severely abnormal.	Lang 2005
Magnetic resonance imaging	Uses the tracing of the contour of myocardial and epicardial border of the left ventricle (in a range of transverse cuts extending across the ventricular chamber) from base to apex; the software performs automated calculation of left ventricular mass. Sex‐specific values of LVH were defined as: left ventricular mass/height ≥ 39 g/m2 (women) and ≥ 48 g/m2 (men). Diagnosis criteria by magnetic resonance imaging: Asymmetric forms of remodelling and hypertrophy were defined as having a septal‐to‐lateral wall thickness ratio > 1.5. Remodeling subtypes: Individuals may be classified by presence or absence of LVH (horizontal axis) and by geometry (vertical axis), depending on mass‐to‐volume ratio. If mass‐to volume ratio is high, geometry is classified as concentric. The paradigm of Khouri 2010 subdivides the 2 LVH classes by whether chamber dilation is present. Imaging magnetic resonance‐based volumetric analysis overcomes the limitation of the use of linear parameters to calculate volume. Their major findings are that concentric or eccentric LVH can each be classified into 2 subgroups, yielding 4 distinct geometric patterns. LVH based on whether or not left ventricular concentricity (to reflect wall thickness) and LVEDV are increased: this approach leads to a 4‐tiered classification of LVH. Increased concentricity without increased LVEDV (“thick hypertrophy”). Increased LVEDV without increased concentricity (“dilated hypertrophy”). Increased concentricity with increased LVEDV (“both thick and dilated hypertrophy”). Neither increased concentricity nor increased LVEDV (“indeterminate hypertrophy”).	Dweck 2012 Khouri 2010
LVED: left ventricular end‐diastolic volume; LVH: left ventricular hypertrophy