Maurice Sokolow
Maurice Sokolow (1911-2002) was an American Cardiologist and educator
Sokolow was known for his contributions to ECG interpretation and hypertension. He is eponymously known for his development of ECG criteria for left ventricular hypertrophy (Sokolow-Lyon criteria), but also made contributions to the development of ambulatory blood pressure measurement.
His work explored the relationship between blood pressure and coronary artery disease; circadian variation in blood pressure as well as contributed to the concept of blood pressure variation and noted that blood pressure recorded during daily life was often lower than that recorded in the Doctor’s office – leading to the concept of “white coat hypertension“
One of his important legacies was his textbook on clinical cardiology which was translated into five languages
Biography
- Born on May 19, 1911 in New York
- 1917 – following the death of his mother at age 6 and with his father unable to care for him, Maurice spent seven years in an orphanage
- graduated UC Berkley
- 1936 – graduated UCSF School of Medicine – recipient of Gold Headed Cane Award (outstanding graduate on his class)
- Residency at the New England Medical Centre (Boston)
- Fellowship in Cardiology at the Michael Reese Hospital (Chicago)
- World War II – served on a hospital ship in the Pacific and developed an interest in tropical diseases
- 1949 – described the ECG characteristics present with left ventricular hypertrophy along with Dr Thomas P Lyon
- 1950s – chief of the hypertension clinic at San Francisco General Hospital Medical Center; founding member of the UCSF Cardiovascular Research Institute
- 1953-1973 chief of cardiology at UC Medical Center
- 1961 – prospective study which developed a portable BP apparatus for automatic blood pressure measurement – initially approaching multiple electronic firms including Hewlett—Packard and Ampex, before working with the Alpha Scientific Corporation and the Remler Company.
- Died from lymphoma on September 26, 2002 at San Francisco, California
Medical Eponyms
Sokolow-Lyon criteria 1949
Sokolow-Lyon Index = SV1 + R (V5 or V6)
The amplitude of the S wave in lead V1 is added to the amplitude of the highest R wave in leads V5 or V6. If the Sokolow-Lyon Index is greater than 3.5 mV (35 mm or 7 large squares) it is suggestive of Left Ventricular Hypertrophy (LVH).
Additional criteria [aVL R wave ≥ 11 mm] is also commonly observed.
The diagnostic significance of the voltage of the left ventricular potentials as reflected by the sum of the R wave in V5 or V6 and the S wave in V1 is emphasized. Thirty-two per cent of patients with left ventricular hypertrophy had the sum of these two potentials exceed 35 mm., whereas in no normal person did this sum exceed 35 mm.; in 96 per cent of normal individuals the sum was found to be below 30 mm.
The single measurement of the sum of the R waves in V5 or V6 (whichever is larger) and the S wave in V1 is an apparently reliable criterion of left ventricular hypertrophy (Table III).
Later criteria include
1968 – D W Romhilt and E Harvey Estes Jr proposed the Romhilt-Estes Left Ventricular Hypertrophy Score: (5 points = definite LVH; 4 points = probable LVH)
A point-score system is presented for the diagnosis of left ventricular hypertrophy from the ECG. It is evaluated in an autopsy series of 150 hearts with hypertrophy designated on the basis of Zeek’s criteria. Using this system, the ECG is positive 60 per cent of the time when LVH is present at autopsy. LVH is diagnosed in 3.2 per cent of nonhypertrophied hearts. The point-score system is significantly more sensitive in the presence of combined hypertension and coronary artery disease than in either alone.
The Romhilt-Estes (R-E) Score, originally proposed for detection of left ventricular hypertrophy (LVH) from the electrocardiogram (ECG), is a strong predictor of all-cause mortality (Estes 2016)
Major Publications
- Sokolow M, Lyon TP. Criteria for the diagnosis of right ventricular hypertrophy using unipolar limb and precordial leads. Am J Med. 1947 Jul;3(1):125.
- Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949 Feb;37(2):161-86.
- Sokolow M, Lyon TP. The ventricular complex in right ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949 Aug;38(2):273-94.
- Sokolow M, Edgar AL. A study of the V leads in congenital heart disease; with particular reference to ventricular hypertrophy and its diagnostic value. Am Heart J. 1950 Aug;40(2):232-51.
- Sokolow M, Edgar AL. Blood Quinidine Concentrations as a Guide in the Treatment of Cardiac Arrhythmias. Circulation, 1950; 1(4): 576-592.
- Grubschmidt HA, Sokolow M. The reliability of high voltage of the QRS complex as a diagnostic sign of left ventricular hypertrophy in adults. Am Heart J. 1957 Nov;54(5):689-94
- Sokolow M, McIlroy MB. Clinical cardiology. 1977 (2e 1979 – 6e 1993)
- Perloff D, Sokolow M, Cowan R. The prognostic value of ambulatory blood pressures. JAMA. 1983 May 27;249(20):2792-8.
- Sokolow M. Ambulatory blood pressure. A personal historical account. Am J Hypertens. 1993 Jun;6(6 Pt 2):161S-165S.
References
Biography
- Maurice Sokolow, MD, pioneer in study of hypertension, dies. UCSF September 30, 2002
- Hall C. Dr. Maurice Sokolow – UCSF cardiologist. SFgate 2002
- Maurice Sokolow. Professor of Cardiology. University of California
Eponymous terms
- Romhilt DW, Estes EH Jr. A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J. 1968 Jun;75(6):752-8.
- ArchiveGrid : E. Harvey Estes Jr. oral history interviews, 1990-2007 (oclc.org)
- Rautaharju P. History of electrocardiology: nine decades of ECG criteria for left ventricular hypertrophy–the contribution of Morice Sokolow and Thomas Lyon. Ann Noninvasive Electrocardiol. 2001 Oct;6(4):342.
- Peguero JG, Lo Presti S, Perez J, Issa O, Brenes JC, Tolentino A. Electrocardiographic Criteria for the Diagnosis of Left Ventricular Hypertrophy. J Am Coll Cardiol. 2017 Apr 4;69(13):1694-1703
- Estes EH, Zhang ZM, Li Y, Tereshchenko LG, Soliman EZ. Individual components of the Romhilt-Estes left ventricular hypertrophy score differ in their prediction of cardiovascular events: The Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2015 Dec;170(6):1220-6.
- ECG in left ventricular hypertrophy (LVH): criteria and implications. ECG Waves
Eponym
the person behind the name
Physician in training. German translator and lover of medical history.
