Normal Standards for Cornell Voltage, Cornell Product and Sokolow-Lyon Voltage

2020 ◽  
Vol 33 (9) ◽  
pp. 831-836 ◽  
Author(s):  
Dian Wang ◽  
Jian-Zhong Xu ◽  
Wei Zhang ◽  
Yi Chen ◽  
Jian Li ◽  
...  

Abstract BACKGROUND Performance of electrocardiographic (ECG) criteria for echocardiographically diagnosed left ventricular hypertrophy (LVH) in Chinese hypertensive patients is not well known. We investigated the accuracy of various ECG criteria for the diagnosis of the echocardiographic LVH according to the new cutoff values of left ventricular mass (LVM) index (>115 g/m2 for men and >95 g/m2 for women) in Chinese hypertensive patients. METHODS Our study included 702 consecutive hypertensive inpatients including 92 (13.1%) concentric and 121 (17.2%) eccentric LVH on standard echocardiography. Diagnostic accuracy of 7 ECG criteria was evaluated by calculating sensitivity and specificity and by using the receiver operating characteristic curves. RESULTS The ECG criteria for the detection of the echocardiographically defined LVH had a sensitivity of 15%–31.9% and specificity of 91.6%–99.2% overall, 20.7%–43.5% and 91.6%–99.2% concentric, and 7.4%–23.1% and 91.6%–99.2% eccentric. ECG diagnosis of LVH defined as the positive diagnosis of any of 4 ECG criteria including Sokolow–Lyon voltage, Cornell voltage, Cornell product, and RavL voltage had a sensitivity of 54% and specificity of 86.3% overall, 71.7% and 86.3% concentric, and 40.5% and 86.3% eccentric. After adjustment for confounding factors, various ECG criteria were significantly correlated with LVM, with standardized β coefficients from 0.20 to 0.39 (P < 0.001) and the highest coefficient for the Cornell product criterion. CONCLUSIONS All ECG LVH indexes had low sensitivity and high specificity in Chinese hypertensive patients. Combination of 4 or all ECG criteria might improve sensitivity without any loss of specificity.


2021 ◽  
Vol 12 (3) ◽  
pp. 2200-2206
Author(s):  
Kranthi Kumar Garikapati ◽  
Yogesh Tripath ◽  
Rinku Garg ◽  
Bindu Garg

Cardiac autonomic neuropathy (CAN) is a frequent and intractable complication of diabetes. Reduction in heart rate variability (HRV) is the first sign of CAN in its subclinical stage. Autonomic imbalance and hyperglycaemia in diabetes are associated with cardiovascular structural and functional modifications, which lead to left ventricular hypertrophy (LVH). The study was undertaken to assess the changes in HRV and left ventricular mass in type 2 diabetes mellitus (T2DM) patients. The case-control study was conducted on 78 T2DM subjects and 78 age & sex-matched healthy controls. CAN be assessed by frequency and time-domain parameters of HRV and LVH was measured using various ECG criteria including Cornell voltage, Cornell product, Sokolow-Lyon voltage, and Romhilt-Estes point score. All the frequency and time-domain parameters of HRV except resting heart rate, normalized LF, and LF/HF ratio were significantly reduced in T2DM patients compared to healthy controls. The prevalence of ECG-LVH was 25.7% using any single criteria and 12.2% with all the criteria. The highest prevalence (24.3%) was noted with Cornell product and Sokolow-Lyon voltage criteria, followed by Romhilt-Estes point score (17.6%) and Cornell voltage criteria (16.2%). Reduction in overall HRV with less high-frequency power and high LF/HF ratio suggests parasympathetic dysfunction and sympathetic predominance. A significant LVH was noted with ECG-based electric criteria in T2DM patients. The study suggests that T2DM patients should be subjected to diagnostic HRV and ECG to identify the early occurrence of CAN and LVH.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Haxha ◽  
U Pedersen-Bjergaard ◽  
J.B Nielsen ◽  
J Pallisgaard ◽  
R.B Devereux ◽  
...  

Abstract Background Cornell voltage criteria (CL) and Sokolow-Lyon criteria (SL) for electrocardiographic left ventricular hypertrophy (ECG-LVH) are well known predictors of cardiovascular outcome. However, their predictive value may differ according to patient type and remains to be further tested in diabetic mellitus (DM) patients. Purpose The present study aims to determine the prevalence of each ECG-LVH criteria and their respective predictive value in DM patients. Method A retrospective cohort study of individuals age >40 years with digital ECGs from primary care were collected during 2001 to 2011. Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. DM was defined if individuals were prescribed oral antidiabetics or insulin, if they were diagnosed with DM type I or II, or had a HbA1c>48 mmol/l. Cox multivariable analysis was used for estimating hazard ratio (HR) and 95% confidence intervals (95% CI) for all-cause mortality during follow-up of up to 17 years. Results Included were 183,749 individuals with a digital ECG collected in primary care. A total of 13,003 (7.1%) individuals had DM, they were older (65.8 vs. 61.3 years), had more myocardial infarction (16.1% vs. 5.2%), stroke (14.4% vs. 6.2%), hypertension (35.1% vs. 13.2%), CL LVH (8.0% vs. 5.6%) and more were males (53.3% vs. 45.3%) compared to the non-DM individuals (all p<0.001). CL identified a larger percentage of LVH in DM compared to non-DM individuals (8.0% vs. 5.6%, p<0.001), whereas SL identified similar percentage LVH in DM and non-DM individuals (8.5% vs. 8.1%, p=0.068). In multivariable adjusted analysis CL LVH remained strongly associated with all-cause mortality [HR 1.45 (95% CI: 1.42–1.48)] compared to SL LVH which found only a modest association [HR 1.06 (95% CI: 1.03–1.10)] (Figure 1). Of note, the association of CL LVH and all-cause mortality was even stronger than DM per se. There was no interaction with DM and either ECG LVH criteria (p>0.45). Conclusion Cornell Voltage Left Ventricular Hypertrophy is a strong predictor of mortality in patients with and without diabetes and an independent risk factor compared to hypertension and diabetes. The predictive value was substantially stronger than Sokolow-Lyon Voltage criteria for hypertrophy. Figure 1. LVH and all-cause mortality Funding Acknowledgement Type of funding source: None


2017 ◽  
Vol 60 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Jonathan Myers ◽  
Leonard A. Kaminsky ◽  
Ricardo Lima ◽  
Jeffrey W. Christle ◽  
Euan Ashley ◽  
...  

PEDIATRICS ◽  
1964 ◽  
Vol 34 (2) ◽  
pp. 157-162
Author(s):  
Peter Gruenwald

Among 5,000 consecutive deliveries there were 536 infants of low birth weight (401-2,500 gm). Those weighing more than 1,000 gm are analyzed according to stated gestational age and normal standards of birth weight for gestational age. The incidence of chronologically mature infants, and of those retarded in intrauterine growth, was determined for infants weighing 1,001-2,000 gm, 1,001-2,250 gm, and 1 001-2,500 gm. Perinatal mortality figures for the various types of infants of low birth weight are given.


2014 ◽  
Vol 175 (1) ◽  
pp. 193-195 ◽  
Author(s):  
Philippe Sosner ◽  
Séverin Cabasson ◽  
Charlotte Hulin-Delmotte ◽  
Pierre-Jean Saulnier ◽  
Elise Gand ◽  
...  

Author(s):  
Emily Xiao ◽  
Augustin Delago ◽  
Mohammad El-Hajjar ◽  
Batyrjan Bulibek ◽  
Mikhail Torosoff

Background and Hypothesis: The sensitivity of LVH analysis by ECG voltage criteria in patients with severe aortic valve stenosis undergoing trans-catheter aortic valve replacement (TAVR) has not yet been studied. LVH is expected in the TAVR population and would be reflected in voltage criteria by ECG. Methods: A retrospective chart review was conducted in 176 consecutive TAVR patients without ventricular-paced rhythm. ECG data was collected and analyzed by Sokolow-Lyon and Cornell Voltage criteria. Results were compared to transthoracic echocardiogram. Analyses of variation, correlation, chi-square, and logistic regression were used. The study was approved by the institutional IRB. Results: Sokolow-Lyon and Cornell Voltage criteria for LVH were present and concordant in 19% (33 of 176) of patients; in 49% (86 of 176) of patients, neither criteria was suggestive for LVH. Only 19% (34 of 176) of patients had LVH by Cornell Voltage and 13% (23 of 176) by Sokolow-Lyon criteria, indicative of poor concordance between these two commonly used ECG criteria for LVH (p<0.0001). Ejection fraction, aortic valve gradient, aortic valve area, COPD, PVD, prior stroke, dyslipidemia, and hypertension did not affect the prevalence of LVH by either or both criteria. Women (p<0.01) and patients with rhythm other than atrial fibrillation (p<0.0053) were more likely to have voltage criteria for LVH, while older adults were more likely to meet criteria for LVH. Concordant LVH criteria were noted in patients 84.6 +/- 7.2 years of age, while patients without LVH by ECG voltage criteria were significantly younger at 80.21 +/- 8.1 years of age (p<0.007). Conclusion: The presence of LVH by Sokolow-Lyon and Cornell ECG voltage criteria poorly correlates with the presence of LVH and critical aortic stenosis in TAVR patients. Women are more likely to have voltage criteria for LVH. Therefore, ECG may not be a suitable method of screening patients with severe aortic stenosis for LVH, especially in men.


2008 ◽  
Vol 17 (3) ◽  
pp. 273-274 ◽  
Author(s):  
Mary G. Carey ◽  
Michele M. Pelter
Keyword(s):  

Sign in / Sign up

Export Citation Format

Share Document