Key result
The Peguero-Lo Presti ECG criteria demonstrated higher sensitivity for diagnosing CMR-defined left ventricular hypertrophy compared to Cornell (47% vs 29%, P<0.001) and Sokolow-Lyon (25%) criteria.
Why the study?
The diagnostic performance of the new Peguero-Lo Presti ECG criteria for left ventricular hypertrophy had not been validated by cardiac magnetic resonance.
Does the Peguero-Lo Presti ECG criteria improve diagnostic sensitivity for left ventricular hypertrophy compared to Cornell and Sokolow-Lyon criteria in patients referred for CMR?
Case-Control (n=240)
Does the Peguero-Lo Presti ECG criteria improve diagnostic sensitivity for left ventricular hypertrophy compared to Cornell and Sokolow-Lyon criteria in patients referred for CMR?
Absolute Event Rate: 47% vs 29%
p-value: p=<0.001
The Peguero-Lo Presti ECG criteria offer significantly higher sensitivity for detecting left ventricular hypertrophy compared to traditional Cornell and Sokolow-Lyon criteria, while maintaining high specificity.
May improve ECG LVH sensitivity in referred patients; leaves open prospective validation before practice change.
AIMS: The diagnostic performance of the new Peguero-Lo Presti ECG criteria for left ventricular hypertrophy (LVH) has not been validated by cardiac magnetic resonance (CMR). The aim of this study was to evaluate and compare the diagnostic performance of Peguero-Lo Presti, Cornell and Sokolow--Lyon voltage criteria for LVH as defined by CMR in an all-comers European population. METHODS: A total of 240 consecutive patients referred for CMR who had a concomitant electrocardiogram for review were evaluated. LVH group patients were defined according to the reference values for sex and age of left ventricular mass index (LVMi). A control group, adjusted by sex, was randomly selected from a population without LVH. We applied the ECG voltage criteria to both groups and evaluated their diagnostic accuracy. Diagnostic sensitivity and specificity were compared. RESULTS: Two hundred and forty patients (mean age 63 years; 65% men) were divided into two groups (LVH n = 149; control n = 91). The main causes of LVH were hypertension (24.8%) and hypertrophic cardiomyopathy (21.5%). The remaining patients of this group had a diagnosis of dilated cardiomyopathy (14.8%), valvular heart disease (7.4%) and infiltrative cardiomyopathy (2.0%). Overall, the sensitivity for LVH diagnosis of the Peguero-Lo Presti criteria outperformed both the Cornell (47 vs. 29%, P < 0.001) and Sokolow--Lyon voltage criteria (vs. 25%, P < 0.001). The specificities of all the criteria were above 94%, without significant differences between them. CONCLUSION: In an all-comers European population with LVH defined by CMR, the criteria of Peguero-Lo Presti showed increased sensitivity for this diagnosis, when compared with the Sokolow--Lyon and Cornell voltage criteria. As such, they could become the preferred ECG diagnostic tool when evaluating patients at risk for LVH.
No takes yet. Share an insight, caveat, or question.
Guerreiro et al. (2020) conducted a case-control in Left ventricular hypertrophy (n=240). Peguero-Lo Presti ECG criteria vs. Cornell and Sokolow-Lyon voltage criteria was evaluated on Diagnostic sensitivity for LVH (p=<0.001). The Peguero-Lo Presti ECG criteria demonstrated higher sensitivity for diagnosing CMR-defined left ventricular hypertrophy compared to Cornell (47% vs 29%, P<0.001) and Sokolow-Lyon (25%) criteria.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: