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Increased inotropy (red loop in figure) increases the slope and shifts the end-systolic pressure-volume relationship (ESPVR) to the left, which permits the ventricle to generate more pressure at a given LV volume. Increased inotropy also increases the rate of pressure development and ejection velocity, which increases stroke volume and ejection .
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The electrocardiogram (ECG) is a useful but imperfect tool for detecting LVH. The utility of the ECG relates to its being relatively inexpensive and widely available. The limitations of the ECG relate to its moderate sensitivity or specificity depending upon which of the many proposed sets of diagnostic criteria are applied [ 1,2 ].
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