ECG-Cornell Criteria Correlating With UCG-LVMI And Its Value In Detection Of Hypertensive Left Ventricular Hypertrophy

Background and Objective Hypertension is one of the commonest cardiovascular diseases. About one-third of the hypertensives may appear left ventricular hypertrophy (LVH); LVH change not only in geometric patterns but also in constructions. The changes lake on concentric or eccentric LVH with the ventricular mass increasing, and then result in cardiac dysfunction and cardiovascular events occurrence, so the earlier detection for heperlensive LVH has a important clinical significance. The hcpcrtcnsivc LVH diagnosis need physical examination, chest x-ray, clcctrocardiography(ECG) and ultrasonic cardiography (UCG) to define it, and it is primarily based on UCG and ECG recently. The corresponding left ventricular mass (LVM) can be obtained by using UCG to measure LV posterior wall thickness(PWT), intervcnlricular septum thickness(IVST) and LV end-diastolie diameler(LVDd). Clinical research confirmed that there was a close relationship between UCG-LVM and autoptic LVH(r=0.96). Left ventricular mass index (LVMI) can be obtained from LVM modified by body surface area(BSA). LVMI can accurely reflect cardiac changes in LVH, the sensitivity of UCG-LVH can attain 88-100%, LVMI become a reliable clinical standard tbr evaluation LVH. Electrocardiography is another often-used method of the detection for LVH, it is easy to practise, trauma-free and economic. But ECG-LVH diagnosis sensitivity is only 1/7-1/10 that of UCG-LVH. The America New York Cornell medical center presented ECG Cornell voltage critcria(Rav1+Sv3) in 1948. Casale considered that the LVH diagrnosis rate of ECG-Cornell was in correspondence with that of UCG-LVH in 1987. Molly and Okin presented Cornell voltage Criteria (Rav1+SV3) exceeded 28mm(male) or 22mm(femalc) in hypertensive LVH andconfirmed its sensitivity, speciaficity, accuracy were better than before. Our strudy will disscuss the Cornell criteria of the normal Chinese people based on LVMI from color Doppler echocardiography, process the research for Chinese hypertensives with LVH and evaluate the diagnosis value of Cornell criteria in hypertensive LVH, which will provide the basis of the detection , diagnosis and progress of treatment in hypertensive LVH.Subjects and Methods: (1)110 normal Cinese people. They are examined through inquiry health history, physical examination, laboratory data, chest x-ray, Echocardio-graphy and blood pressure measurement SBP<140mmHg DBP<90mmHg (1999 WHO/ISH hypertension guidelines). UCG-LVMI measurement process according to American society of echocardiography (ASE) recommending ASE convention, LVDd, PWT, IVST are measured from long axis view of left ventricle beside sternum and end-diastolic 2-dimension of left ventricle, M-mode UCG at the level of mitral orifice of left ventricle capturing samples and the average value can be obtained through three cardiac cycles measuring constantly in expiration state, according to Devereux modified formula to calculate: LVM(g)=0.8xl.04[(IVST+PWT+LVDd)3-LVDd3]+0.6 LVMI(g/m2) = LVM/BSA UCG-LVMI<125g/m2(male) , <115g/m2 (female) are normals. ECG conventional record with each parameter measured from three cardiac cycles and the average value can be obtained. All subjects undergo ECG and UCG in the same day. (2) 110 normal subjects group. Cornell voltage limits(Ravi+Sv3) can be defined from the upperdata of the normal value range(x 1.645) by 12-lead ECG. (3) UCG and ECG Cornell criteria of 90 subjects with hypertensive LVH are studied and then compare with other ECG Voltage such as RI, RV5, Ravi, Ri+SIII, RV5+Sv1, their sensitivity, speciaficity, accuracy are assessed. (4) evaluate the correlationship between the respective ECG-LVH voltage criteria and hypertensive LVH, disscuss the clinical value of Cornell voltage criteria for hypertensive LVH. (5) statistical analysis of the data is performed using SPSS10.0, P=0.05 is regarded as statistical level.Result: (1) Chinese people Cornell voltage, male mean is (15.40 5.43)mm, female mean is (13.26 4.28)mm, their upper limits are 24.16mm(male), 20.28mm(female) from95% normal range (x...