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Diffuse Myocardial Fibrosis Reduces Electrocardiographic Voltage Measures of Left Ventricular Hypertrophy Independent of Left Ventricular Mass by Maren Maanja, Björn Wieslander, Todd T. Schlegel, Ljuba Bacharova, Hussein Abu Daya, Yaron Fridman, Timothy C. Wong, Erik B. Schelbert, and Martin Ugander J Am Heart Assoc Volume 6(1):e003795 January 22, 2017 © 2017 Maren Maanja et al. Flow chart of patient selection. Maren Maanja et al. J Am Heart Assoc 2017;6:e003795 © 2017 Maren Maanja et al. Differences in voltage/mass ratio with regards to extracellular volume fraction (ECV). Maren Maanja et al. J Am Heart Assoc 2017;6:e003795 © 2017 Maren Maanja et al. Linear correlations between ECG measures and left ventricular mass index (LVMI) and extracellular volume fraction (ECV). Maren Maanja et al. J Am Heart Assoc 2017;6:e003795 © 2017 Maren Maanja et al. Example of a 24‐year‐old woman illustrating the coexistence of normal QRS amplitudes on the ECG in patients with high left ventricular mass index (LVMI) and increased myocardial extracellular volume fraction (ECV). Maren Maanja et al. J Am Heart Assoc 2017;6:e003795 © 2017 Maren Maanja et al.