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&C��z4JJJ% % % 9B;B;B;B;B;B;B$�E�rHP_B��% % % % % _B��JJ��B	$	$	$% F�J�J9B	$% 9B	$	$Vo*@3+J���� ��x�����k ��*%B�B0&C�*x�H!��H3+3+n�H��+�% % 	$% % % % % _B_B	$% % % &C% % % % ���������������������������������������������������������������������H% % % % % % % % % � �:	Validation of Cornell Product as a method of assessing left ventricular hypertrophy

Samir Rafla1, Tarek Elzawawy 1, Omar Ismail Elbahy 2, Amr Kamal Mohamed 1, Ali Elshourbagy Abo Ali 2
Cardiology and angiology Department, Faculty of Medicine, Alexandria University, 1 cardiology unit, medical research institute Alexandria University, 2 Egypt
Address for correspondence: Prof. Samir Rafla, smrafla@yahoo.com
 
Background: LV diastolic dysfunction (DD) and diastolic HF is a major and widely spreaded     health proplem and it�s associated with higher cardiovascular morbidity and all cause mortality, ECG �LVH is studied as an early predictor of LV diastolic dysfunction.

Methods: diastolic dysfunction is evaluated in 100 patients with  Cornell product (CP) criteria >2440 mm.ms with complete evaluation of diastolic function via mitral inflow velocities (mitral E velocity, A velocity and E/A ratio ), tissue Doppler imaging( septal and lateral annular velocity, E/E� ratio), deceleration time, isovolumic relaxation time, left atrial Enlargement, left ventricular mass index.

Results: Among the 100 patients (59% female and 41 % males ), 14 % presented with normal diastolic function , while 86% had diastolic dysfunction with different grades , with increasing values of CP with more progression of the diastolic dysfunction severity, in concern to the echocardiographic parameters there were progressively higher values of LVEDD, PWD,IVSD,LVMI,E/A ratio, E/E� ratio and LAVI  with advancement of diastolic dysfunction ; while there were inverse relation between the diastolic dysfunction severity and (E-velocity, a-velocity , lateral E� velocity and DT).
The IVRT shows higher values with mild degree of diastolic dysfunction then with progression of diastolic dysfunction there were progressive reduction in IVRT values, while there were no significant difference in concern of LVESD and septal E� velocity between normal population and different grades of diastolic dysfunction .

Conclusions: CP LVH is a strong predictor of presence of Diastolic dysfunction and with higher degrees of diastolic dysfunction; the CP LVH was higher indicating good predictor for the severity of diastolic dysfunction.

Key Words: Cornell product _ left ventricular hypertrophy _ diastolic dysfunction _ heart failure_ Echocardiography.

Abbreviations: Diastolic dysfunction = DD, Left ventricular ejection fraction = LVEF, Diastolic heart failure= DHF; left atrial volume =LAV; left ventricular hypertrophy (LVH); Heart failure with preserved ejection fraction= HFpEF; Transthoracic echo= TTE; Cornell product= CP; Cornell voltage= CV; Left atrial volume index= LAVI; 

Introduction
Diastolic dysfunction and consequently diastolic heart failure is a major public health problem, it accounts for more than 1 million hospitalizations per year in the United States. (1-3)
Epidemiologic data obtained within the past 20 years, since the concept of heart failure with normal LVEF was introduced, show that its prevalence is 30%�74% (median 45%).(4-6)
Population-based studies showed that at least 40%�50% of all patients with heart failure have a normal or near normal LVEF and that DHF is most common among patients older than 75 years. Identifying patients with asymptomatic diastolic dysfunction may allow the implementation of non pharmacological or pharmacological interventions aiming at reversing heart functional and structural abnormalities, thus delaying the onset of symptomatic HF. 
The onset of HFpEF is preceded by diastolic abnormalities such as slowing in relaxation and alterations in the filling pressures and structure of the left ventricle (LV) � left ventricular hypertrophy (LVH), and increased left atrial volume (LAV). Thus, it is important to detect these abnormalities in a preclinical phase. (7) 
Hypertension is major risks for HF development, (8, 9).Mechanisms by which LVH can negatively influence diastolic function and contribute to development of HFpEF are thought to include abnormal LV relaxation and passive stiffness associated with increased LV mass. (10�12).
Increased ECG LVH by Cornell product is an independent predictor of diastolic dysfunction (13) and an effective predictor of increased LV mass (14�17). Therefore, the aim of this study was to correlates the persistence of Cornell product ECG LVH at with echocardiographic LV diastolic function to show the availability of using Cornell product as a powerful indictor for diastolic dysfunction.
Methods: 

Study population:
One hundred patients who underwent ECG for different causes at Alexandria main university Hospital- were selected according to the presence of ECG - LVH Cornell product with a cut-of value for the Cornell product equal 2440 mm.ms or more. Transthoracic echocardiography (TTE) was done for all patients and they undergone evaluation of diastolic function. Subjects were excluded if they met any of the following criteria: LV ejection fraction <40%; age less than 18 year; having  ECG criteria that does not meet the Cornell product; hypertrophic cardiomyopathy; pericardial constriction; congenital heart diseases; acute pulmonary embolism, right or left bundle branch block; atrial or ventricular arrhythmia .

Electrocardiography	

Standard 12-lead ECGs were recorded by skilled ECG technicians at 25 mm/s and 1 mV/cm according to standard American Heart Association recommendations. (18)
Patient's results were interpreted blindly from TTE results. All subjects whose ECG demonstrated sinus rhythm and  meeting  the Cornell product �LVH with a cut-of value  2440 mm.ms were included in the study. If more than one ECG was available, the ECG closest in time to TTE was selected for analysis. ECG measurements included QRS duration, heart rate, Cornell voltage criteria and Cornell product. 
LVH was calculated using sex-specific Cornell product (CP) criteria: [sum of the R wave in aVL plus the S wave in V3, plus 8 mm in women] � QRS duration; as well as Cornell Voltage (CV) criteria: sum of the R wave in aVL plus the S wave in V3.(19-20)
 All ECG variables were recorded by a physician independent of ECG or TTE interpretation.
Echocardiography
Confirmation of LVH in all patients included in the study was done via Echocardiography by calculation of left ventricular mass index.
All subjects underwent Full echocardiographic study and assessment of diastolic dysfunction was done using several echocardiography parameters; mitral inflow velocities (mitral E velocity, A velocity and E/A ratio), tissue Doppler imaging (septal and lateral annular velocity, E/E� ratio), deceleration time, isovolumetric relaxation time, left atrial Enlargement according to standard guidelines.21�23
Using standardized principles, each subject�s diastolic function was graded as normal, abnormal relaxation (Stage I), pseudo normal (Stage II), and restrictive (Stage III).21-23 
Statistical Analyses
All statistical analyses were performed using SPSS, version 19.0 (SPSS Inc., Chicago, IL, USA) with a 2-tailed P < 0.05 considered statistically significant. Data are presented as mean � SD for continuous variables and as percentages for categorical variables. Chi-square tests and independent t-tests were used for comparison of categorical and continuous variables, respectively.


RESULTS
Study Group
One hundred patients selected according to their Cornell product values, of which 86 (86%) had DD diagnosed by TTE. Characteristics of all subjects and the comparison between those with and without DD revealed no statistical difference between the two groups as regards sex, age, weight, height, BMI, and BSA.
There was no significant between subjects without DD and those with DD according to demographic data but patients with DD had higher prevalence of hypertension compared to those with normal diastolic function, while there was no difference between both groups according to the other predisposing factor of diastolic dysfunction as smoking, diabetes, ischemic heart disease and valvular heart disease.

ECG data for patients with diastolic dysfunction and with normal diastolic function are in table, those with diastolic dysfunction had a higher values for Cornell product mean CP was 2953 � 492 mm�ms for the whole group and with detailed analysis of different grades of DD the mean CP was higher with advancement of DD; mean CP was, 2833�459 mm.ms, 3080�485 mm.ms, 3550�636 mm.ms for grade I, II and III respectively.
  While the mean QRS duration was 98 � 11.7 for the whole group and with detailed analysis of different grades of DD the mean QRS was higher with advancement of DD; mean QRS was 96 � 12.6ms, 100 � 12.6ms, 100 � 0.0ms for grade I, II and III respectively.
Table (1):	Comparison between the two groups according to ECG data (n=100)
ECG data Mean � SD.Without DD(n = 14)With DD(n = 86)tpHR82.50 � 12.1481.45 � 14.560.800QRS width88.57 � 10.2798.14 � 11.730.001CV26.86 � 4.2026.85 � 4.310.995CP2650� 1982953 � 492<0.001
DD= diastolic dysfunction, HR; heart rate, CV; Cornell voltage, CP; Cornell product
P: p value for student t-test comparing between the two studied groups
Statistically significant at p d" 0.05

Compared with patients without DD, whose mean CP was 2650 � 198 mm.ms and mean QRS was 88 � 10.2ms.  While there was no significant difference between both groups concerning Cornell voltage criteria and heart rate. Table 1- 4

Table (2):	Relation between grade of D.D and ECG data (n=100)
ECG data Mean � SDGrade of D.DFpNone (n = 14)I(n = 48)II(n = 36)III(n = 2)HR82 � 12.183 � 14.979 � 13.977 � 17.60.580QRS width87 � 9.996 � 12.6100 � 12.6100 � 0.0<0.004CV26.8 � 4.226.8 � 4.626.5 � 3.831.5 � 0.70.480CP2608�2022833�4593080�4853550�636<0.001P: p value for F-ANOVA test comparing between the studied groups
 Statistically significant at p d" 0.05

According to echocardiographic findings patients with DD had more abnormal IVSD, PW, LAVI, lateral E�, E/E�; they also had higher indexed LV mass. 
There was no difference in LV ejection fraction or LV internal diastolic and systolic  dimension between groups,  E�velocity , A-velocity , E/A ratio, septal e� velocity , DT and IVRT .
With detailed comparison of different grades of DD there were significant difference between the different groups concerning all Echocardiographic parameters except LV internal systolic dimension and septal E� velocity .table 3-4
Table (3):	Comparison between the two groups according to Echo parameters
Echo parameters 
Mean � SD.Without DD(n = 14)With DD(n = 86)tpLVEDD 47 � 6.745.8 � 4.740.522LVESD29.8 � 3.729.8 � 3.80.990LVMI94 � 14117 � 17<0.001EF64.7 � 5.862.5 � 7.90.318LVSD11.7 � 2.5713.7 � 1.360.014PW11.2 � 2.413.2 � 1.20.010E�VEL75.6 � 15.770.2 � 21.30.3A�VEL74.3 � 15.682.4 � 25.20.2P: p value for student t-test comparing between the two studied groups
 Statistically significant at p d" 0.05. LVSD= LV septal diameter


Table (4):		Comparison between the populations in different grades of DD according to Echo parameters 
Echo parameters Mean � SDGrade of D.DFpNone (n = 14)I(n = 48)II(n = 36)III(n = 2)LVEDD  47 � 6.744 � 4.5447 � 4.5951 � 1.980.034LVESD  29.8 � 3.729.7 � 4.330 � 3.1628.5 � 2.10.949LVMI  94 � 14110� 11.85123� 17.22164 � 4.95<0.001EF  64.7 � 5.860.7 � 8.764� 672 � 40.031IVSD11.7 � 2.5713.7 � 1.1313.6 � 1.6115 � 1.41<0.001PW 11 � 2.413 � 1.2113 � 1.2214 � 0.71<0.001E�VEL  75.6 � 15.761.8 � 17.880.8 � 21.580 � 7<0.001A�VEL  74 � 15.686 � 2179 � 28.438 � 3.5<0.02E/A1.08 � 0.360.72 � 0.131.06 � 0.362 � 0.01<0.001Septal E'�V8.7 � 1.576.9 � 8.805.4 � 1.145.4 � 0.070.386Lateral E'�V12.3 � 2.507.5 � 1.527.4 � 1.546.0 � 0.21<0.001E/E'7.7 � 0.789.7 � 3.4212.7 � 3.0414.5 � 0.71<0.001LAVI21.8 � 6.2724.2 � 8.6435.6 � 13.248 � 14.14<0.001DT244 � 35.57253 � 39.37182 � 21.23136 � 30.41<0.001IVRT116 �35.76129 �28.96103 �23.2148 � 5.66<0.001
P: p value for F-ANOVA test comparing between the studied groups
Statistically significant at p d" 0.05


DISCUSSION

CP LVH and DD

The study showed that ECG LVH by CP is strongly associated with the presence of echocardiographic DD in patients with a preserved ejection fraction.  The other significant ECG parameter of DD was QRS duration. These findings suggest that increased CP LVH can identify patients in need of further cardiovascular evaluation of possible underlying DD.
This goes with the result of a recent cohort study to show whether ECG CP- LVH is associated with LV diastolic dysfunction (DD) of patients who underwent both cardiac computed topographic angiography and transthoracic echocardiography (TTE) with complete evaluation of diastolic function, The presence of DD was determined via evaluation of mitral inflow velocities, tissue Doppler imaging, deceleration time, isovolumetric relaxation time, pulmonary venous systolic: diastolic ratio, and left atrial enlargement. 
The study concluded that Cornell product ECG LVH is a powerful predictor of the presence of diastolic dysfunction. (24)
Also, Krepp et al. (25) In his a cross-sectional analysis of patients who underwent ECG, echocardiography and coronary CT angiography found a strong association between Cornell product LVH and diastolic dysfunction after adjustment for potential risk factors when Cornell product LVH exceeded the 75th percentile value of 1595mm_ms Previous studies from LIFE have demonstrated that incident HF is significantly related to changing levels of both ECG LVH and echocardiographic LVH. (26, 27)
And In an analysis of the large subset of the overall LIFE study population without a history of previous HF,(26 )Greater regression of Cornell product LVH was strongly associated with a reduced incidence of HF hospitalizations, independent of other potential HF risk factors. Further examination of the subset of the LIFE study population that also underwent echocardiography demonstrated that both ECG and echocardiographic LVH independently contributed to the increased risk of developing new HF. These findings suggested that the relationship between changing levels of ECG LVH and HF risk might be mediated at least in part by differences in LV systolic and/or diastolic function. (27)
This goes with what Kim SJ. et al (28) in a prospective observational study to compare the prognostic significance of commonly used ECG criteria for LVH (Sokolow-Lyon voltage (SV) or voltage-duration product (SP) and Cornell voltage (CV) or voltage-duration product (CP) criteria, and to investigate the association between echocardiographic LV mass index (LVMI) and ECG-LVH criteria in ESRD patients, who consecutively started maintenance hemodialysis, Found that The product of QRS voltage and duration is helpful in identifying the presence of LVH and predicting cardiovascular mortality in incident HD patients. (28)
Joji Ishikawa et al. studied levels of Cornell Voltage and Cornell Product for predicting cardiovascular and stroke mortality and morbidity. They concluded that Cardiovascular and stroke risks may be elevated at lower levels of CV and CP in Japanese subjects, especially females. (29)

Study limitation 
The study revealed the relationship between CP LVH and presence of mild and moderate degrees of diastolic dysfunction but may not be applicable to patients with severe diastolic dysfunction because of the small number of population in the group with restrictive filling pattern which can be targeted later on in different studies.
We did not calculate other methods of assessing LVH as Sokolow-Lyon�index or Romhilt-Estes point score system.
CONCLUSION
Our study shows that increased value of Cornell product LVH voltage criteria is strongly correlated to diastolic dysfunction and the Cornell product LVH is better and more significant predictor for diastolic dysfunction than Cornell voltage criteria of LVH, The study also showed that the QRS duration is also highly correlated to diastolic dysfunction and may be the cause for significance of the Cornell product LVH criteria over the Cornell voltage criteria as a predictor of diastolic dysfunction.
We found also that of the echocardiographic parameters of diastolic dysfunction the E/A ratio, deceleration time and left atrial volume index were significant parameters of abnormal diastolic function.
Conflict of interest: None
Funds: no funds received from any place.

References
HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Hunt%20SA%5BAuthor%5D&cauthor=true&cauthor_uid=16160202"Hunt SA. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to update the 2001 guidelines for the evaluation and management of heart failure). J Am Coll Cardiol 2005; 46:e1-82.
Swedberg K, HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Cleland%20J%5BAuthor%5D&cauthor=true&cauthor_uid=15901669"Cleland J,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Dargie%20H%5BAuthor%5D&cauthor=true&cauthor_uid=15901669"Dargie H,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Drexler%20H%5BAuthor%5D&cauthor=true&cauthor_uid=15901669"Drexler H,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Follath%20F%5BAuthor%5D&cauthor=true&cauthor_uid=15901669"Follath F,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Komajda%20M%5BAuthor%5D&cauthor=true&cauthor_uid=15901669"Komajda M,�et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J 2005; 26:1115-40.
De Frances CJ, Podgornik MN. 2004 National Hospital Discharge Survey. Adv Data 2006; 371:1-19.
Hogg K, Swedberg K, McMurray J. Heart failure with preserved left ventricular systolic function. Epidemiology, clinical characteristics and prognosis. J Am Coll Cardiol 2004; 43(3):317-27.
Thomas MD, HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Fox%20KF%5BAuthor%5D&cauthor=true&cauthor_uid=14984719"Fox KF,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Coats%20AJ%5BAuthor%5D&cauthor=true&cauthor_uid=14984719"Coats AJ,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Sutton%20GC%5BAuthor%5D&cauthor=true&cauthor_uid=14984719"Sutton GC. The epidemiological enigma of heart failure with preserved systolic function. Euro J Heart Fail 2004; 6(2):125-36.
Vasan RS, Benjamin EJ, Levy D. Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective. J Am Coll Cardiol 1995; 26(7):1565-74.
 Ammar KA, Jacobsen SJ, Mahoney DW, Kors JA, Redfield MM, et al. Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation. 2007; 115(12):1563-70.
 Lloyd-jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002; 106: 3068�3072.
 Levy D, Larson MG, Vasan RS, et al. The progression from hypertension to congestive heart failure. JAMA. 1996; 275:1557�1562.
 De Simone G, Gottdiener JS, Chinali M, et al. Left ventricular mass predicts heart failure not related to previous myocardial infarction: the Cardiovascular Health Study. Euro Heart J. 2008; 29:741�747.
 Matsugata H, Senda S, Inukai M, et al. Differences in left ventricular diastolic dysfunction between eccentric and ventricular diastolic dysfunction between eccentric and concentric left ventricular hypertrophy in hypertensive patients with preserved systolic function. J Int Med Res. 2011; 39:772�779.
 Zile MR, Baicu CF, Gaash WH. Diastolic heart failure- abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004;350: 1953�1959.
 Krepp J, Lin F, Min J, et al. Relationship of electrocardiographic left ventricular hypertrophy to the presence of diastolic dysfunction. Ann Noninvasive Electrocardiol. 2014; 19:552�560.
  Joji Ishikawa, Shizukiyo Ishikawa, Tomoyuki Kabutoya, et al. Cornell Product Left Ventricular Hypertrophy in Electrocardiogram and the Risk of Stroke in a General Population. Hypertension. 2009;53:28-34.) 
 Syed�M�Afzal�Sohaib,  John�R�Payne, Rajeev�Shukla; et al. Electrocardiographic (ECG) criteria for determining left ventricular mass in young healthy men; data from the�LARGE Heart�study. Journal of Cardiovascular Magnetic Resonance 200911:2
 Okin PM, Roman MJ, Devereux RB, et al. Electrocardiographic diagnosis of left ventricular hypertrophy by the time-voltage integral of the QRS complex. J Am Coll Cardiol. 1994; 23:133�140.
  HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Sundstr%C3%B6m%20J%5BAuthor%5D&cauthor=true&cauthor_uid=11352882" Sundstr�m J,� HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Lind%20L%5BAuthor%5D&cauthor=true&cauthor_uid=11352882" Lind L,� HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Arnl%C3%B6v%20J%5BAuthor%5D&cauthor=true&cauthor_uid=11352882" Arnl�v J,� HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Zethelius%20B%5BAuthor%5D&cauthor=true&cauthor_uid=11352882" Zethelius B,� HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Andr%C3%A9n%20B%5BAuthor%5D&cauthor=true&cauthor_uid=11352882" Andr�n B,� HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Lithell%20HO%5BAuthor%5D&cauthor=true&cauthor_uid=11352882" Lithell HO. Echocardiographic and electrocardiographic diagnosis of left ventricular hypertrophy predicts mortality independently of each other in a population of elderly men. Circulation. 2001; 103:2346�2351.
 Report of committee on electrocardiography, American Heart Association. Recommendations for standardization of leads and of specifications for instruments in electrocardiography and vector cardiography. Circulation 1967; 35:583� 602.
 Molloy TJ, Okin PM, Devereux RB, Kligfield P. Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration product. J Am Coll Cardiol 1992; 20:1180-6.
Okin PM, Devereux RB, Jern S, HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Kjeldsen%20SE%5BAuthor%5D&cauthor=true&cauthor_uid=15547161"Kjeldsen SE,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Julius%20S%5BAuthor%5D&cauthor=true&cauthor_uid=15547161"Julius S,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Nieminen%20MS%5BAuthor%5D&cauthor=true&cauthor_uid=15547161"Nieminen MS,�et al. Regression of electrocardiographic left ventricular hypertrophy during antihypertensive treatment and the prediction of major cardiovascular events. JAMA 2004; 292:2343-9.
 Nagueh SF, Appleton CP, Gillebert TC, et al. Recommendations for the evaluation of left ventricular diastolic function by 2009
Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: A report from the American Society of Echocardiography�s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogram 2005; 18:1440�1463.
 Qui�nones MA, Otto CM, Stoddard M, et al. Recommendations for quantification of Doppler echocardiography: A report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogram 2002; 15:167�184.
Krepp JM,�Lin F, Min JK,�Devereux RB, Okin PM. Cornell Product Criteria for Left Ventricular Hypertrophy Strongly Predicts the Presence of Diastolic Dysfunction. Circulation�2012; 126:A9398.
Krepp J,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Lin%20F%5BAuthor%5D&cauthor=true&cauthor_uid=24750238"Lin F,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Min%20JK%5BAuthor%5D&cauthor=true&cauthor_uid=24750238"Min JK,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Devereux%20RB%5BAuthor%5D&cauthor=true&cauthor_uid=24750238"Devereux RB,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Okin%20PM%5BAuthor%5D&cauthor=true&cauthor_uid=24750238"Okin PM. Relationship of electrocardiographic left ventricular hypertrophy to the presence of diastolic dysfunction. Ann Noninvasive Electrocardiol 2014; 19:552-60.

26-Okin PM, Devereux RB, Harris KE, HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Jern%20S%5BAuthor%5D&cauthor=true&cauthor_uid=17785486"Jern S,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Kjeldsen%20SE%5BAuthor%5D&cauthor=true&cauthor_uid=17785486"Kjeldsen SE,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Julius%20S%5BAuthor%5D&cauthor=true&cauthor_uid=17785486"Julius S, et al. Regression of electrocardiographic left ventricular hypertrophy is associated with less hospitalization for heart failure in hypertensive patients. Ann Intern Med 2007; 147:311-9.
27. Gerdts E, Okin PM, Boman K,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Wachtell%20K%5BAuthor%5D&cauthor=true&cauthor_uid=22456225"Wachtell K,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Nieminen%20MS%5BAuthor%5D&cauthor=true&cauthor_uid=22456225"Nieminen MS,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Dahl%C3%B6f%20B%5BAuthor%5D&cauthor=true&cauthor_uid=22456225"Dahl�f BU`acrst���������濭���yfR�f?f+'h�&h�I�CJH*OJPJQJ^JaJ$h�&h�I�CJOJPJQJ^JaJ'h�&h�%�CJH*OJPJQJ^JaJ$h�&h�%�CJOJPJQJ^JaJ h�&h�I�CJOJQJ^JaJ#h�&h�I�CJH*OJQJ^JaJ h�&h�%�CJOJQJ^JaJ#h�&h�I�CJH*OJQJ^JaJ h�&h�I�CJOJQJ^JaJ+h�S%B*CJKH$OJPJQJ^JaJph1h�&h#MzB*CJKH$OJPJQJ^JaJphTU�X	�	�	�
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GGGG}G~G�G�G�G�G�G�G.H/H7H8H���������������������������������������������������������������������� h�&hJnCJOJQJ^JaJU h�&h_'CJOJQJ^JaJ)jh�&h�q�CJOJQJU^JaJ h�&h�q�CJOJQJ^JaJH, et al. Association of heart failure hospitalizations with combined electrocardiography and echocardiography criteria for left ventricular hypertrophy. Am J Hypertens 2012; 25:678-83?
28. HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Kim%20SJ%5BAuthor%5D&cauthor=true&cauthor_uid=22530043"Kim SJ,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Oh%20HJ%5BAuthor%5D&cauthor=true&cauthor_uid=22530043"Oh HJ,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Yoo%20DE%5BAuthor%5D&cauthor=true&cauthor_uid=22530043"Yoo DE,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Shin%20DH%5BAuthor%5D&cauthor=true&cauthor_uid=22530043"Shin DH,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Lee%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=22530043"Lee MJ,�HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/?term=Kim%20HR%5BAuthor%5D&cauthor=true&cauthor_uid=22530043"Kim HR,�et al. Electrocardiographic left ventricular hypertrophy and outcome in hemodialysis patients. HYPERLINK "https://www.ncbi.nlm.nih.gov/pubmed/22530043" \o "PloS one."PLoS One�2012; 7(4):e35534.
29. Joji Ishikawa, MD, PhD; Shizukiyo Ishikawa, MD, PhD; Kazuomi Kario, MD, PhD; Jichi Medical School (JMS) Cohort Study Investigators Group. Levels of Cornell Voltage and Cornell Product for Predicting Cardiovascular and Stroke Mortality and Morbidity in the General Japanese Population. Circ J 2014; 78: 465 � 475













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