Key result
CAR2E2 score identifies CMR-defined LVH with ~0.76 AUC.
Why the study?
Left ventricular hypertrophy is linked to adverse clinical outcomes and affects clinical decision-making, prompting the evaluation of different approaches for screening.
Does the CAR2E2 score improve the prediction and screening for left ventricular hypertrophy compared to standard radiographic or ECG parameters in patients with cardiovascular diseases?
Cross-Sectional (n=55)
Single-blind
No
Does the CAR2E2 score improve the prediction and screening for left ventricular hypertrophy compared to standard radiographic or ECG parameters in patients with cardiovascular diseases?
The novel CAR2E2 score, combining simple clinical, radiographic, and ECG parameters, enhances the diagnostic screening sensitivity for left ventricular hypertrophy over individual metrics alone.
CAR2E2 may aid LVH screening in CVD patients; hypothesis-generating and should not change practice without prospective validation.
Left ventricular hypertrophy (LVH) is associated with adverse clinical outcomes and implicates clinical decision-making. The aim of our study was to assess the importance of different approaches in the screening for LVH. We included patients who underwent cardiac magnetic resonance (CMR) imaging and had available chest radiograph in medical documentation. Cardiothoracic ratio (CTR), transverse cardiac diameter (TCD), clinical and selected electrocardiographic (ECG)-LVH data, including the Peguero-Lo Presti criterion, were assessed. CMR−LVH was defined based on indexed left ventricular mass-to-body surface area. Receiver operating characteristics analyses showed that both the CTR and TCD (CTR: area under the curve: [AUC] = 0.857, p < 0.001; TCD: AUC = 0.788, p = 0.001) were predictors for CMR−LVH. However, analyses have shown that diagnoses made with TCD, but not CTR, were consistent with CMR−LVH. From the analyzed ECG−LVH criteria, the Peguero-Lo Presti criterion was the best predictor of LVH. The best sensitivity for screening for LVH was observed when the presence of heart failure, ≥40 years in age (each is assigned 1 point), increased TCD and positive Peguero-Lo Presti criterion (each is assigned 2 points) were combined (CAR2E2 score ≥ 3 points). CAR2E2 score may improve prediction of LVH compared to other approaches. Therefore, it may be useful in the screening for LVH in everyday clinical practice in patients with prevalent cardiovascular diseases.
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Matusik et al. (2022) conducted a cross-sectional in Left Ventricular Hypertrophy (n=55). CAR2E2 score vs. Individual clinical, chest radiograph, and electrocardiographic criteria was evaluated on Prediction of CMR-defined left ventricular hypertrophy (CMR-LVH) (AUC 0.763, p=<0.001). The CAR2E2 score ≥ 3 points (combining clinical, chest radiograph, and ECG criteria) was a significant predictor of left ventricular hypertrophy identified by cardiac magnetic resonance (AUC 0.763, p<0.001).
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