Department of Cardiology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China,
Department of Prevention, School of Medicine, Tongji University, Shanghai, People's Republic of China.
Clin Interv Aging. 2019 Mar 11;14:549-556. doi: 10.2147/CIA.S180723. eCollection 2019.
Left ventricular hypertrophy (LVH) is one of the preclinical manifestations of hypertensive target organ damage (TOD). However, it remains unclear which electrocardiographic criterion perform better in diagnosing LVH.
To investigate the consistency of LVH diagnosed by electrocardiography (ECG) and echocardiography (ECHO). Taking LVH by ECHO as reference, to compare three different ECG criteria (Sokolow-Lyon, Cornell and Cornell Product criteria) and find the best ECG indicator for identifying LVH in community-based elderly Chinese.
Echocardiography and electrocardiography were applied to define LVH in 1789 elderly Chinese aged >65 years old in communities located at the northern Shanghai. Echocardiographic LVH (ECHO-LVH) was defined by left ventricular mass indexed for Body Surface Area (LVM/BSA) or for height (LVM/height). Electrocardiographic LVH (ECG-LVH) was defined by Sokolow-Lyon (SL), Cornell and Cornell Product (CP) criteria. ECHO-LVH was defined by LVM/BSA≥125 g/m in male or ≥110 g/m in female (LVH1); LVM/BSA≥115 g/m in male, or ≥95 g/m in female (LVH2) and LVM/height ≥51 g/m in male or ≥47 g/m in female (LVH3).
As compared with SL and Cornell criteria, CP had the greatest correlation coefficient in the association with echocardiography-defined LVH, except for LVM/BSA in men. Of note, CP criterion had the greatest area under curve of ROC than Cornell criterion and the SL index, not only in total population but also in subgroups classified by blood pressure.
In ECG-LVH criteria, CP criterion complies better than SL index and Cornell criterion in assessing cardiac hypertrophy.
左心室肥厚（LVH）是高血压靶器官损害（TOD）的临床前表现之一。然而，目前尚不清楚哪种心电图标准在诊断 LVH 方面表现更好。
研究心电图（ECG）诊断的 LVH 与超声心动图（ECHO）的一致性。以 ECHO 诊断的 LVH 为参考，比较三种不同的心电图标准（Sokolow-Lyon、Cornell 和 Cornell 乘积标准），并找到用于识别社区中中国老年人心血管肥大的最佳心电图指标。
对位于上海北部社区的 1789 名年龄 >65 岁的老年人进行了超声心动图和心电图检查，以确定 LVH。超声心动图 LVH（ECHO-LVH）通过左心室质量指数（LVMI）/体表面积（BSA）或身高（LVMI/身高）来定义。心电图 LVH（ECG-LVH）通过 Sokolow-Lyon（SL）、Cornell 和 Cornell 乘积（CP）标准来定义。ECHO-LVH 通过男性的 LVM/BSA≥125 g/m2 或女性的 LVM/BSA≥110 g/m2（LVH1）；男性的 LVM/BSA≥115 g/m2，或女性的 LVM/BSA≥95 g/m2（LVH2）和男性的 LVM/身高≥51 g/m2 或女性的 LVM/身高≥47 g/m2（LVH3）来定义。
与 SL 和 Cornell 标准相比，CP 标准与超声心动图定义的 LVH 的相关性系数最大，除了男性的 LVM/BSA。值得注意的是，CP 标准的 ROC 曲线下面积大于 Cornell 标准和 SL 指数，不仅在总人群中，而且在按血压分类的亚组中。
在心电图 LVH 标准中，CP 标准在评估心脏肥大方面比 SL 指数和 Cornell 标准更符合。
