### Description

Casale et al proposed criteria for the electrocardiographic diagnosis of left ventricular hypertrophy (LVH). They were shown by the authors to be more sensitive while being specific for the diagnosis. Since these were developed at the Cornell Medical Center, they are also referred to as the Cornell criteria.

Cornell Voltage Criteria

voltage sum =

= (S in V3 in mV) + (R in aVL in mV)

where:

• 1 mm = 0.1 mV

Interpretation:

• LVH is present in a male if sum > 2.8 mV

• LVH is present in a female if sum > 2.0 mV

Multiple Logistic Regression Equation:

Patients with Normal Sinus Rhythm

exponent =

= 4.558 - (0.092 * ((R in aVL in mm) + (S in V3 in mm)) - (0.306 * (T in V1 in mm)) - (0.212 * (QRS duration in hundredths of a second)) - (0.278 * (P terminal force in V1 in mm*sec)) - (0.559 * (sex value))

where

• sex value = 1 if male, 2 if female

• QRS duration in hundredths of a second = ((QRS duration in seconds) * 100)

• P terminal force is the area of the terminal negative deflection of the P wave

Interpretation

• LVH present if exponent < -1.55

Multiple Logistic Regression Equation:

Patients with Atrial Fibrillation

exponent =

= 5.045 - (0.093 * ((R in aVL in mm) + (S in V3 in mm)) - (0.312 * (T in V1 in mm)) - (0.325 * (QRS duration in hundredths of a second)) - (0.602 * (sex value))

where:

• sex value = 1 if male, 2 if female

Interpretation:

• LVH present if exponent < -1.20

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