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Updated: Jul 6, 2026

Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Thresholds in the relationship between mortality and left ventricular hypertrophy defined by electrocardiography
Edward P Havranek1, Caroline D B Emsermann, Desiree N Froshaug
1Department of Medicine, Denver Health Medical Center, Denver, Colorado 80204-4507, USA.ehavrane@dhha.org
New electrocardiographic criteria for left ventricular hypertrophy (LVH) were developed using mortality data. These novel criteria show promise for better clinical risk assessment and patient outcomes.
Area of Science:
- Cardiology
- Medical Diagnostics
- Public Health
Background:
- Current electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) rely on autopsy or echocardiography.
- LVH criteria validated against mortality data may offer greater clinical relevance.
Purpose of the Study:
- To identify ECG measures that predict 5-year survival.
- To establish mortality-based thresholds for LVH diagnosis.
Main Methods:
- Utilized data from the Third National Health and Nutrition Examination Survey (NHANES III).
- Selected ECG measures discriminating between survivors and non-survivors at 5 years.
- Employed regression techniques to identify voltage thresholds and compared survival rates.
Main Results:
- Cornell voltage, Cornell product, and Novacode index demonstrated discriminative power for mortality.
- The Novacode index showed significant associations with 5-year all-cause and cardiovascular mortality, independent of systolic blood pressure.
- Identified thresholds for these ECG measures in relation to mortality risk.
Conclusions:
- ECG criteria for LVH validated against mortality data are potentially clinically useful.
- This approach may enhance the diagnostic and prognostic value of ECG in identifying LVH.
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