title: Does QRS Voltage Correction by Body Mass Index Improve the Accuracy of Electrocardiography in Detecting Left Ventricular Hypertrophy and Predicting Cardiovascular Events in a General Population?
abstract: The authors assessed the value of body mass index (BMI) correction of two electrocardiographic criteria in improving detection of left ventricular hypertrophy (LVH) and prediction of cardiovascular and all-cause mortality in the Italian study Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) population. At entry, 1549 patients underwent diagnostic tests, 24-hour ambulatory blood pressure (BP) monitoring, standard electrocardiography, and echocardiography. The BMI-corrected Cornell voltage and Sokolow-Lyon voltage criteria provided better results for detection of echocardiographic LVH as compared with unadjusted electrocardiographic parameters. Cornell voltage index, but not Sokolow-Lyon index, was associated with an increased risk of cardiovascular events (and all-cause mortality). The adjusted risk of cardiovascular events related to one-standard deviation increment of BMI-corrected Cornell voltage was similar to that conferred by the uncorrected criterion in the total population, but outperformed in obese participants. These findings show that correction for BMI may improve the diagnostic accuracy of Cornell voltage index in detecting LVH and prediction of cardiovascular mortality in obese individuals.
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.|Istituto Auxologico Italiano IRCCS, Milano, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.affiliation: Department of Clinical Sciences and Community Health University of Milano and Fondazione Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.affiliation: University Clinical Hospital Centre "Dragisa Misovic", Belgrade, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.|IRCCS Multimedica, Milano, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.affiliation: Department of Health Science, University of Milano-Bicocca, Milano, Italy.|Istituto Auxologico Italiano IRCCS, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000503:physiopathology; D007558:Italy; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results