Validation of Cornell Product as a Method of Assessing Left Ventricular Hypertrophy

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.

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Cornell Product Left Ventricular Hypertrophy in Electrocardiogram and the Risk of Stroke in a General Population

Hypertension ◽

10.1161/hypertensionaha.108.118026 ◽

2009 ◽

Vol 53 (1) ◽

pp. 28-34 ◽

Cited By ~ 49

Author(s):

Joji Ishikawa ◽

Shizukiyo Ishikawa ◽

Tomoyuki Kabutoya ◽

Tadao Gotoh ◽

Kazunori Kayaba ◽

...

Keyword(s):

General Population ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Cornell Product

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Study of Cardiac Autonomic Neuropathy and Left Ventricular Hypertrophy in type-II diabetic patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i3.4834 ◽

2021 ◽

Vol 12 (3) ◽

pp. 2200-2206

Author(s):

Kranthi Kumar Garikapati ◽

Yogesh Tripath ◽

Rinku Garg ◽

Bindu Garg

Keyword(s):

Heart Rate ◽

Left Ventricular Hypertrophy ◽

Autonomic Neuropathy ◽

Time Domain ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Cardiac Autonomic Neuropathy ◽

Healthy Controls ◽

Cornell Voltage ◽

Cornell Product

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.

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Abstract 1936: Cornell Product Left Ventricular Hypertrophy In Electrocardiogram Is A Strong Predictor Of Stroke In Community-dwelling Japanese Normotensives

Circulation ◽

10.1161/circ.116.suppl_16.ii_417 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Joji Ishikawa ◽

Shizukiyo Ishikawa ◽

Kazunori Kayaba ◽

Kazuyuki Shimada ◽

Kazuomi Kario

Keyword(s):

General Population ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Cox Regression ◽

Left Ventricular ◽

Community Dwelling ◽

Cox Regression Analysis ◽

Increased Risk ◽

Japanese General Population ◽

Cornell Product

Background : Incidence of stroke is higher than ischemic heart disease in Japanese. Left ventricular hypertrophy (LVH) is associated with an increased risk for stroke among hypertensives. We evaluated the risk of LVH among normotensives (SBP/DBP<120/80 mmHg) subjects. Methods: In a Japanese general population, 10755 subjects who were undertaken electrocardiogram and measured BP at baseline were evaluated Cornell product (CP) and Sokolow-Lyon (SL) voltage as markers of LVH (CP≥2440 mm ms and SL voltage>35 mm). Follow-up was performed for 10 years and incidence of stroke was evaluated. Results: Prevalence of CP-LVH were 2.7% for normotensives, 5.2 % for prehypertensives, 11.0 % for hypertensives, and that of SL-LVH were 8.6%, 11.4%, and 22.5%, respectively. In overall subjects, CP-LVH and SL-LVH were independent predictors of stroke [CP-LVH: hazard risk (HR) 1.65, 95% confidence interval (CI) 1.22–2.25, SL-LVH: HR 1.30, 95%CI 1.02–1.65] after adjustment for confounding factors. In Cox regression analysis in each stage of hypertension, hazard ratios of stroke in subjects with CP-LVH were higher among normotensives (HR 8.28, 95%CI 3.72–18.41) than among prehypertensives (HR 1.56, 95%CI 0.67–3.63) and hypertensives (HR 1.48, 95%CI 1.02–2.13) (Figure ), although that in subjects with SL-LVH were not significant (normotensives: HR 1.54, 95%CI 0.70–3.40, prehypertensives: HR 1.29, 95%CI 0.72–2.32, hypertensives: HR 1.21, 95%CI 0.90–1.62). Conclusion: The ECG-LVH independently predicted future stroke in a Japanese general population. The specificity of the Cornell product-LVH is higher than that of Sokolow-Lyon-LVH especially among normotensive subjects <120/80 mmHg.

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Abstract 2180: Relationship of Left Ventricular Systolic Function to Persistence or Development of Electrocardiographic Left Ventricular Hypertrophy in Hypertensive Patients: Implications for the Development of New Heart Failure

Circulation ◽

10.1161/circ.116.suppl_16.ii_473 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Peter M Okin ◽

Kristian Wachtell ◽

Eva Gerdts ◽

Kurt Boman ◽

Markku S Nieminen ◽

...

Keyword(s):

Heart Failure ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Diastolic Pressure ◽

Systolic Function ◽

Left Ventricular ◽

Lv Function ◽

Increased Risk ◽

Cornell Product

Background : We have previously demonstrated that persistence or development of ECG left ventricular hypertrophy (LVH) by Cornell product criteria are associated with an increased risk of developing heart failure (HF) compared with regression or continued absence of LVH. We postulated that this relationship might be in part mediated via worse LV systolic function in patients with new and persistent LVH. Methods : Baseline and year-3 ECG LVH and LV midwall shortening (MWS) were examined in 725 patients in the LIFE echocardiographic substudy. MWS was measured and considered abnormal if <14.2%; stress-corrected MWS (scMWS) was considered abnormal if 2440 mm-msec. Results : Between baseline and 3 years follow-up, there was continued absence (n=260) or regression (n=167) of LVH in 427 patients and persistence (n=259) or development (n=39) of ECG LVH in 298 patients. Although there was no difference in baseline prevalence of abnormal MWS (23.4 vs 26.5%, p=0.389) or abnormal scMWS (24.6 vs 26.4%, p=0.663) between groups, after 3 years follow-up persistence or development of new LVH was associated with significantly lower mean MWS and scMWS and with higher prevalence and odds of abnormal MWS and scMWS than continued absence or regression of LVH (Table ). After controlling for differences in age, gender, race, treatment group, baseline and change from baseline to year-3 of heart rate, Sokolow-Lyon voltage, systolic and diastolic pressure and baseline severity of LVH by Cornell product, persistent or new ECG LVH remained associated with a >2-fold increased risk of abnormal MWS or scMWS at year 3. Conclusions : Persistence or development of new ECG LVH during antihypertensive therapy is associated with an increased risk of LV systolic dysfunction after 3 years of follow-up. These findings provide insight into a possible mechanism by which changes in ECG LVH are associated with changing risk of developing HF. < Midwall LV Function in Relation to Persistence or Development of ECG LVH Between Baseline and Year-3

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Electrocardiographic left ventricular hypertrophy Cornell product is a feasible predictor of cardiac prognosis in patients with chronic heart failure

Clinical Research in Cardiology ◽

10.1007/s00392-013-0646-2 ◽

2013 ◽

Vol 103 (4) ◽

pp. 275-284 ◽

Cited By ~ 7

Author(s):

Yoichiro Otaki ◽

Hiroki Takahashi ◽

Tetsu Watanabe ◽

Shinpei Kadowaki ◽

Taro Narumi ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Cornell Product

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Features of arterial hypertension patients with discrepancies in vectorcardiographic and echocardiographic conclusions about the presence of left ventricular hypertrophy [Original Article]

Systemic Hypertension ◽

10.26442/2075082x.2019.3.190444 ◽

2019 ◽

Vol 16 (3) ◽

pp. 13-18

Author(s):

Elena V Blinova ◽

Tamara A Sakhnova ◽

Olga Ya Chaykovskaya ◽

Marina A Saidova ◽

Galina V Ryabykina

Keyword(s):

Blood Pressure ◽

Left Ventricular Hypertrophy ◽

Arterial Hypertension ◽

Systolic Blood Pressure ◽

Diastolic Dysfunction ◽

Ventricular Hypertrophy ◽

False Negative ◽

Left Ventricular ◽

True Negative ◽

Cornell Product

Aim. To determine the features of patients with arterial hypertension (AH) with a discrepancy of electrocardiographic, including vectorcardiographic (VCG) and echocardiographic conclusions about the presence of left ventricular hypertrophy (LVH). Materials and methods. 140 patients with AH were examined (mean age 59.8±12.0 years, 33.6% of men). The Sokolov- Lyon criterion, the Cornell product, the sum of the amplitudes of the R wave in lead X and the S wave in lead Z of the synthesized vectorcardiogram (RX+SZ) and the amplitude of the maximal QRS vector (MQRS) were analyzed. Left ventriclular myocardial mass (LVMM) was calculated using the ASE formula, LVMM/height2.7 more than 44 g/m2.7 in women and more than 48 g/m2.7 in men was considered a criterion for LVH.Results. In patients with AH, pathological RX+SZ and MQRS values were significantly more frequent compared with the Sokolov-Lyon criterion and the Cornell product. Pathological values of RX+SZ and MQRS were met both in patients with an increased and with a normal indexed LVMM. Patients with "true-positive" VCG findings compared with "false-negative" had significantly larger values of the relative wall thickness, LVMM and indexed LVMM. Patients with “false positive” VCG findings compared with “true-negative” were more likely to have left ventricular diastolic dysfunction (90% and 68%, respectively). Patients with the presence of VCG criteria for LVH, both with normal and with an increased indexed LVMM, were characterized by higher values of systolic blood pressure and higher values of the QRS duration. Conclusion. In patients with arterial hypertension, pathological values of vectorcardiographic indices were significantly more frequent compared with the Sokolov-Lyon criterion and the Cornell product. VCG indices allowed to separate groups of patients with the presence and absence of diastolic dysfunction of the left ventricle, as well as groups of patients with normal and elevated values of systolic blood pressure.

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