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March 1, 1987Circulation

Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings.

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Why the study?

Do Cornell voltage and regression criteria improve the diagnostic accuracy of electrocardiograms for detecting left ventricular hypertrophy compared to standard Sokolow-Lyon criteria?

Population

135 patients with antemortem electrocardiograms and left ventricular muscle mass measured at autopsy

Comparison

Cornell voltage criteria and logistic regression… vs Standard Sokolow-Lyon voltage criteria

Design

Cohort

Authors

PCPaul N. CasaleRDRichard B. DevereuxDAD R Alonso

Discussion

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Overview

Regression criteria improve ECG accuracy for LVH; extends echo-based validation but leaves open prospective outcome confirmation.

Key Points

  • This research aims to validate improved electrocardiographic criteria for diagnosing left ventricular hypertrophy (LVH) using autopsy findings as a reference.
  • Developed two sets of voltage criteria for LVH detection: Cornell voltage criteria and regression-based criteria.
  • Compared antemortem electrocardiograms to left ventricular mass measured at autopsy in 135 patients.
  • Evaluated sensitivity and specificity of standard and new criteria for diagnostic performance.
  • Sensitivity of Sokolow-Lyon voltage criteria was 22%, specificity 100%.
  • Cornell voltage criteria improved sensitivity to 42% and specificity to 96%.
  • Regression criteria showed highest sensitivity at 62% with specificity at 92%, overall accuracy improved to 77% (p < .005 vs SLV).

Structured PICO

Do Cornell voltage and regression criteria improve the diagnostic accuracy of electrocardiograms for detecting left ventricular hypertrophy compared to standard Sokolow-Lyon criteria?

P
Population
135 patients with antemortem electrocardiograms and left ventricular muscle mass measured at autopsy
I
Intervention
Cornell voltage criteria (RaVL + SV3 > 2.8 mV in men and > 2.0 mV in women) and logistic regression criteria for electrocardiographic diagnosis of left ventricular hypertrophy
C
Comparator
Standard Sokolow-Lyon voltage (SLV) criteria (SV1 + RV5 or RV6 > 3.5 mV)
O
Outcome
Sensitivity, specificity, and overall test accuracy for detecting left ventricular hypertrophy using autopsy left ventricular muscle mass as the reference standardsurrogate

Cornell voltage and regression criteria significantly improve the sensitivity and overall accuracy of electrocardiograms for detecting left ventricular hypertrophy compared to standard Sokolow-Lyon criteria, validated against autopsy findings.

Cite This Study

Casale et al. (1987) studied this question.

synapsesocial.com/papers/6a12a281fb24b1a422a5d2c5https://doi.org/10.1161/01.cir.75.3.565
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Current diagnostic ECG criteria for left ventricular hypertrophy: is it time to change paradigm in the analysis of data?2019 · 29 citations
  2. 2Classification Accuracy of Electrocardiographic Criteria for Left Ventricular Hypertrophy in Normal Weight and Overweight Older Adults1996 · 10 citations
  3. 3Age, sex, hypertension and the sensitivity and specificity of traditional, new and a machine learning ECG criteria for prediction of left ventricular hypertrophy2025 · 2 citations
  4. 4Validity of electrocardiographic criteria for increased left ventricular mass in young patients in the general population2017 · 7 citations
  5. 5Detection of Left Ventricular Hypertrophy by Different Electrocardiographic Criteria in Clinical Practice. Findings From the Sara Study2010 · 23 citations