Cornell Voltage–Duration Product (CVDP): Explanation and Clinical Context The Cornell Voltage–Duration Product (CVDP) is a refined electrocardiographic index developed to improve the detection of left ventricular hypertrophy (LVH) by integrating both voltage magnitude and QRS duration. It was proposed by Molloy et al. (Circulation, 1992) based on data from the Cornell and Framingham studies.
Formula: CVDP = (R in aVL + S in V3 [+ 0.8 mV for females]) × QRS duration (ms)
Diagnostic Threshold:
A value of >2440 mV·ms indicates LVH, with higher specificity compared to voltage criteria alone. The adjustment of +0.8 mV for females corrects for sex-related voltage differences.
Normal Values:
- < 2440 mV·ms: Normal (No LVH)
- > 2440 mV·ms: Suggestive of LVH
Clinical Significance:
CVDP correlates more closely with echocardiographic LV mass than traditional voltage criteria such as Sokolow–Lyon or simple Cornell Voltage alone. It enhances diagnostic accuracy, particularly in populations with low ECG voltage (e.g., obese or female patients). Moreover, CVDP has prognostic value, being independently associated with increased cardiovascular morbidity and mortality, even after adjustment for other risk factors.
Clinical Interpretation Summary:
The Cornell Voltage–Duration Product provides a more physiologically integrated approach to LVH detection by accounting for both myocardial mass (voltage) and depolarization time (duration). Its use can improve clinical decision-making and refine cardiovascular risk stratification.
Reference:
Molloy TJ, Okin PM, Devereux RB, et al. Electrocardiographic detection of left ventricular hypertrophy by the Cornell Voltage–Duration Product. Circulation. 1992;86(3):807–814. doi:10.1161/01.CIR.86.3.807