[Electrocardiographic criteria for left ventricular hypertrophy and cardiovascular risk in hypertensives. VIIDA study]

José R González-Juanatey, Luis Cea-Calvo, Vicente Bertomeu, Joaquín Aznar et al.
Revista Española de Cardiología 2007, 60 (2): 148-56

INTRODUCTION AND OBJECTIVES: To determine whether Cornell and Sokolow-Lyon criteria identify different groups of patients with left ventricular hypertrophy (LVH), and whether there is a relationship between hypertrophy severity and the prevalence of cardiovascular disease.

METHODS: Cross-sectional multicenter study carried out in cardiology departments on hypertensive patients with electrocardiographic LVH, as defined by Cornell or Sokolow-Lyon criteria. Blood pressure (BP) and clinical and laboratory data were recorded. The study population was divided into quartiles according to electrocardiographic findings to enable relationships with cardiovascular disease to be evaluated.

RESULTS: Overall, 3074 patients with LVH were studied: 978 (31.8%) met both LVH criteria, 1244 (40.5%) met Cornell criteria only, and 852 (27.7%) met Sokolow-Lyon criteria only. Fulfillment of Sokolow-Lyon criteria was associated with male gender, a low body mass index (BMI), a low prevalence of diabetes, and a high prevalence of myocardial infarction. Fulfillment of Cornell criteria was associated with female gender, a high BMI, and a high prevalence of diabetes. Fulfillment of both criteria was associated with poor BP control and a high prevalence of heart failure. Associations were observed between LVH severity and the prevalence of cardiovascular disease: the adjusted odds ratio for the upper versus the lower quartile was 1.65 (P=.011) for Sokolow-Lyon criteria, 1.59 (P=.014) for Cornell criteria, and 2.03 (P=.001) for both combined.

CONCLUSIONS: Sokolow-Lyon and Cornell criteria identify patients with different high-risk cardiovascular risk profiles. Consequently, it would be preferable to use both criteria as this would increase the detection rate of electrocardiographic LVH. Moreover, there is a relationship between the severity of electrocardiographic LVH and the prevalence of established cardiovascular disease.

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