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

Ernest Vinyoles, Teresa Rodriguez-Blanco, Mariano De La Figuera, Josep M. Colomé, Marta Tafalla, Núria Calbet, M. Isabel Fernández-San Martin, Judit García-Alonso, Cristina Murillo, Josep Agudo

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    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. © 2012 Scandinavian Foundation for Cardiovascular Research.
    Original languageEnglish
    Pages (from-to)352-359
    JournalBlood Pressure
    Volume21
    Issue number6
    DOIs
    Publication statusPublished - 1 Dec 2012

    Keywords

    • Electrocardiographic variability
    • Hypertension
    • Left ventricular hypertrophy

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    Vinyoles, E., Rodriguez-Blanco, T., De La Figuera, M., Colomé, J. M., Tafalla, M., Calbet, N., Fernández-San Martin, M. I., García-Alonso, J., Murillo, C., & Agudo, J. (2012). Variability and concordance of Cornell and Sokolow-Lyon electrocardiographic criteria in hypertensive patients. Blood Pressure, 21(6), 352-359. https://doi.org/10.3109/08037051.2012.686180