Related Experiment Video

Updated: Aug 6, 2026

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
10:08

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine

Published on: February 17, 2018

Electrocardiographic left ventricular hypertrophy and sudden cardiac death

Konsta Kivimäki1, Leo-Pekka Lyytikäinen2, Kjell Nikus3

  • 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

International Journal of Cardiology
|July 17, 2026
PubMed

Insights

The Cornell product criterion for electrocardiographic left ventricular hypertrophy (ECG LVH) showed the strongest association with sudden cardiac death (SCD) in high-risk patients. However, the overall predictive performance for SCD events was modest.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Preventive Cardiology

Background:

  • Electrocardiographic left ventricular hypertrophy (ECG LVH) is linked to sudden cardiac death (SCD).
  • Limited comparative data exist on different ECG LVH criteria in high-risk populations.
  • Studies often lack evaluation in diverse coronary syndromes and non-coronary artery disease populations.

Purpose of the Study:

  • To compare the association between multiple ECG LVH criteria and SCD events.
  • To evaluate these associations in patients with acute and chronic coronary syndromes, including those without significant coronary artery disease.
  • To assess the discriminative ability of each criterion for predicting SCD.

Main Methods:

  • Retrospective analysis of 19,220 patients from two cohorts.
  • Evaluation of seven ECG LVH criteria: Sokolow-Lyon, Cornell voltage, Cornell product, Peguero-Lo Presti, MESA, RaVL, and Romhilt-Estes.
  • Fine-Gray subdistribution hazard models and time-varying Cox proportional hazards models were used to assess associations with SCD, accounting for competing risks.

Main Results:

  • The Cornell product criterion demonstrated the strongest association with SCD events (SHR 1.29; p=0.003) in multivariable analyses.
  • This association remained consistent in time-varying models and after excluding patients with reduced ejection fraction.
  • The discriminative ability of ECG LVH criteria for SCD was modest (AUC 0.67).

Conclusions:

  • The Cornell product criterion is most strongly associated with SCD events among evaluated ECG LVH criteria, even after risk factor adjustment.
  • This association holds true whether LVH is present at baseline or develops during follow-up.
  • Despite the strongest association, the overall predictive power of ECG LVH criteria for SCD remains modest.
Abstract

Keywords:
ElectrocardiographyLeft ventricular hypertrophySudden cardiac death

Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...