285
Views
4
CrossRef citations to date
0
Altmetric
Research Article

Variability and concordance of Cornell and Sokolow–Lyon electrocardiographic criteria in hypertensive patients

, , , , , , , , & show all
Pages 352-359 | Received 12 Jan 2012, Accepted 29 Mar 2012, Published online: 16 May 2012
 

Abstract

Aim. To assess the variability and concordance of left ventricular hypertrophy electrocardiographic (LVH-ECG) criteria. Methods and Results. Convenience sampling of hypertensive subjects without coronary disease or bundle branch blocks. Two electrocardiograms (ECGs) were performed on each patient. Two investigators carried out two blind-readings of each ECG (Cornell and Sokolow–Lyon criteria). The between-rater and within-rater reliability were assessed (intraclass correlation coefficient, ICC). Poor concordance was defined: mean voltage difference between both ECGs >2 mm; 824 ECG readings were performed in 103 subjects (58.3% females), aged 66.8±8.8 years, mean blood pressure 141±15.10/78±9.0 mmHg. The between-rater ICCs of the baseline ECG were 0.97(95% CI 0.96–0.98) and 0.98 (95% CI 0.97–0.99) for Cornell and Sokolow–Lyon criteria, respectively. Poor concordance was found in 39.8% and in 41.7% of the cases for Cornell and Sokolow–Lyon criteria, respectively. Systolic blood pressure was found to be significant and positively associated with both criteria. Elderly hypertensive subjects, with higher ECG voltages and lower pulse pressure presented poor concordance of Cornell criteria. Conclusions. The between-rater and within-rater reliability of Cornell and Sokolow–Lyon criteria is minimal. Approximately 40% of hypertensive subjects presented poor concordance in a second ECG. Older patients with lower pulse pressure and higher baseline voltages presented poorer reproducibility of LVH-ECG criteria.

Acknowledgements

The present study was possible thanks to the grant: [1r Ajut per al desenvolupament de projectes de recerca, 2008. Institut Català de la Salut. IDIAP Universitari Jordi Gol.]

Conflict of interest: The authors declare no conflict of interest.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.