{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T13:41:39Z","timestamp":1774791699536,"version":"3.50.1"},"reference-count":46,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Key Research","award":["2017YFC1307600"],"award-info":[{"award-number":["2017YFC1307600"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The sensitivity of ECG for detecting left ventricular hypertrophy (LVH) is low. The aim of this study was to explore a better ECG criterion for screening LVH in a large general Chinese population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>China Medical University in Shenyang, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>All permanent residents in Dawa, Zhangwu and Liaoyang aged 35 years or older were invited. Participants with unqualified data, pacemaker rhythm, frequent premature ventricular beats, Wolff-Parkinson-White syndrome, complete bundle branch block, myocardial infarction or hypertrophic cardiomyopathy were excluded. A total of 10\u2009360 subjects (4630 males) were recruited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>A novel ECG criterion (Northeast China Rural Cardiovascular Health Study (NCRCHS)) composed of different ratios of maximum R wave in lead V<jats:sub>5<\/jats:sub> or V<jats:sub>6<\/jats:sub> (R<jats:sub>V5\/V6<\/jats:sub>), S wave in lead V<jats:sub>3<\/jats:sub> (S<jats:sub>V3<\/jats:sub>) and R wave in lead aVL (R<jats:sub>aVL<\/jats:sub>) was proposed and validated using multiple linear regression. Receiver-operating characteristic curves were used to compare the NCRCHS criterion with traditional criteria for LVH detection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An optimised model (15<jats:sup>*<\/jats:sup>R<jats:sub>aVL<\/jats:sub>+8<jats:sup>*<\/jats:sup>S<jats:sub>V3<\/jats:sub>+7<jats:sup>*<\/jats:sup>R<jats:sub>V5\/V6<\/jats:sub>) was constructed (R<jats:sup>2<\/jats:sup> 0.192, p&lt;0.001) with the cut-off values of 36.8\u2009mV for males and 26.1\u2009mV for females. The maximum area under the curve was obtained using the NCRCHS criterion (male 0.74, 95% CI 0.73 to 0.75; female 0.73, 95%\u2009CI 0.72 to 0.75), followed by Cornell voltage criterion, Sokolow-Lyon criterion, Peguero-Lo Presti criterion, multi-ethnic study of atherosclerosis (MESA)-specific criterion and Syst-Eur voltage criterion. Compared with the Cornell voltage criterion, the NCRCHS criterion had a significantly higher sensitivity for detecting LVH at the same level of specificity (p&lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The NCRCHS criterion significantly improved sensitivity for LVH detection in a general Chinese population, with cut-off values of 36.8 and 26.1\u2009mV for males and females, respectively. This criterion can detect LVH earlier and better and may prevent subsequent cardiovascular diseases.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2021-051172","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T05:43:43Z","timestamp":1644817423000},"page":"e051172","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Performance of a novel ECG criterion for improving detection of left ventricular hypertrophy: a cross-sectional study in a general Chinese population"],"prefix":"10.1136","volume":"11","author":[{"given":"Yanli","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guozhe","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaofan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0318-3490","authenticated-orcid":false,"given":"Guangxiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongmei","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shasha","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0101-9398","authenticated-orcid":false,"given":"Liqiang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1961-899X","authenticated-orcid":false,"given":"Yingxian","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"2022021320030440000_11.9.e051172.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199005313222203"},{"key":"2022021320030440000_11.9.e051172.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.03.023"},{"key":"2022021320030440000_11.9.e051172.3","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/j.amjcard.2019.06.003","article-title":"Interrelation between electrocardiographic left atrial abnormality, left ventricular hypertrophy, and mortality in participants with hypertension","volume":"124","author":"Ahmad","year":"2019","journal-title":"Am J Cardiol"},{"key":"2022021320030440000_11.9.e051172.4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(49)90562-1"},{"key":"2022021320030440000_11.9.e051172.5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.40.2.185"},{"key":"2022021320030440000_11.9.e051172.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.12.063"},{"key":"2022021320030440000_11.9.e051172.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"2022021320030440000_11.9.e051172.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80115-7"},{"key":"2022021320030440000_11.9.e051172.9","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90376-X"},{"key":"2022021320030440000_11.9.e051172.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000142169.17298.54"},{"key":"2022021320030440000_11.9.e051172.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.12.035"},{"key":"2022021320030440000_11.9.e051172.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.037"},{"key":"2022021320030440000_11.9.e051172.13","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"2022021320030440000_11.9.e051172.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.11.006"},{"key":"2022021320030440000_11.9.e051172.15","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90771-X"},{"key":"2022021320030440000_11.9.e051172.16","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90385-Z"},{"key":"2022021320030440000_11.9.e051172.17","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"2022021320030440000_11.9.e051172.18","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.41.6.899"},{"key":"2022021320030440000_11.9.e051172.19","unstructured":"Chou TC , Helm RA , Kaplan S . 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