Sokolow-Lyon index:
There are two criteria with these widely used indices:
* Sum of S wave in V1 and R wave in V5 or V6 >/= 3.5 mV (35 mm)
and/or
* R wave in aVL >/= 1.1 mV (11 mm)
Romhilt-Estes point score system:
Probable left ventricular hypertrophy is diagnosed if 4 points are present and definite left ventricular hypertrophy is diagnosed if 5 or more points are present.
|
Criterion |
Points |
|
Any limb R wave or S wave >/=2.0 mV (20 mm) |
3 |
|
ST-T wave changes typical of LVH |
|
|
Left atrial abnormality |
|
|
Left axis deviation >/= -30ª |
2 |
|
QRS duration >/= 90 ms |
1 |
|
Intrinsicoid deflection in V5 or V6 >/= 50 ms (0.05 sec) * |
1 |
* Intrinsicoid deflection is defined as interval between beginning of QRS interval and the peak of the R wave
Cornell voltage criteria – These more recent criteria are based upon echocardiographic correlative studies designed to detect a left ventricular mass index >132 g/m2 in men and >109 g/m2 in women.
-
For men: S in V3 plus R in aVL >2.8 mV (28 mm)
-
For women: S in V3 + R in aVL >2.0 mV (20 mm)
Cornell voltage-duration measurement
-
QRS duration×Cornell Voltage > 2440 ms × mV
Sensitivity and specificity for selected ECG criteria of LVH
|
Criterion |
Sensitivity (%) |
Specificity (%) |
|
Sokolow Lyon Voltage |
22 |
100 |
|
Cornell Voltage Criteria |
42 |
96 |
|
Cornell Voltage Duration Criteria |
51 |
95 |
|
RaVL > 11 mm |
11 |
100 |
|
Romhilt-Estes > 4 points |
54 |
85 |
|
Romhilt-Estes > 5 points |
33 |
94 |
Limbs leads:
- R in 1 + S in 3 more than 25 mm
- R in aVL more than 7.5 mm
Chest leads:
- S in V1 or V2 + Rin V5 or V6,ore than 35 mm
- R in V5 or V6 more than 26
- R + S in any V lead more than 45 mm
References:
- de Vries SO, Heesen WF, Beltman FW, Kroese AH, May JF, Smit AJ, Lie KI. Prediction of the left ventricular mass from the electrocardiogram in systemic hypertension. Am J Cardiol. 1996 May 1;77(11):974-8. [Medline]
- Casale PN, Devereux RB, Alonso DR, Campo E, Kligfield P. Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings. Circulation. 1987 Mar;75(3):565-72.[Medline]
- Okin PM, Roman MJ, Devereux RB, Kligfield P. Gender differences and the electrocardiogram in left ventricular hypertrophy. Hypertension. 1995 Feb;25(2):242-9. [Medline]
Created: Jan 03, 2006
