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LV hypertrophy can be either secondary, in response to pressure or volume overload, or primary, i.e. not explained solely by abnormal loading conditions.
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Markedly delayed LV relaxation in the setting of elevated LV filling pressures allows for ongoing LV filling in mid diastole and thus L velocity. Patients usually have bradycardia. When present in patients with known cardiac disease (e.g., LVH, HCM), it is specific for elevated LV filling pressures. However, its sensitivity is overall low.
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