Refining Diagnostic Performance Of The Cornell Product ECG Criteria For Left Ventricular Hypertrophy (LVH): Is It Reliable Among Hypertensive Patients?

Background: Left ventricular hypertrophy (LVH) is an adaptive response to hypertension. The Cornell Product (CP) criteria, combining Cornell voltage and QRS duration in Electrocardiogram (ECG), is a widely used method for diagnosing LVH due to its sensitivity in detecting changes in the left ventricle’s electrical activity and structure. The CP criteria remain one of the most accessible and effective ECG-based methods for LVH detection in hypertensive populations. However, research on the diagnostic performance remains limited. Methods: This study aimed to evaluate the diagnostic accuracy of the CP criteria in hypertensive patients. A cross-sectional design was employed with normal group (41) and LVH group (74). Results: Age was the most significant predictor of left ventricular geometry (LVG) (adjusted p-value 0.000, OR 9.01, 95% CI 2.81-28.9). The correlation between LVH detection using ECG with CP criteria and echocardiography was not significant (p-value 0.513). At the standard threshold of ≥2440 mmms, the CP criteria showed a sensitivity of 16.22% and high specificity of 88%. After modifying the cutoff to ≥1240 mmms, sensitivity improved to 55.41% and specificity to 58%. Conclusion: while the CP criteria show high specificity, their sensitivity for detecting LVH remains suboptimal, though adjusting the cutoff enhances diagnostic performance.