Key result
The Peguero-Lo Presti ECG criterion showed 17.5% sensitivity and 94.5% specificity for detecting left ventricular hypertrophy, with a modest predictive capability (AUC 0.64) similar to Cornell criteria.
Why the study?
Existing ECG criteria for left ventricular hypertrophy have low sensitivity, prompting the prospective testing of the novel Peguero-Lo Presti criterion in unselected cardiac patients.
Does the Peguero-Lo Presti ECG criterion improve the diagnostic accuracy of left ventricular hypertrophy compared to established criteria in unselected cardiac patients?
Observational (n=767)
Single-blind
No
Does the Peguero-Lo Presti ECG criterion improve the diagnostic accuracy of left ventricular hypertrophy compared to established criteria in unselected cardiac patients?
Effect estimate: AUC 0.64 (95% CI 0.56-0.68)
Absolute Event Rate: 0.64% vs 0.67%
p-value: p=<0.01
The novel Peguero-Lo Presti ECG criterion offers higher sensitivity for detecting left ventricular hypertrophy than traditional criteria but maintains only modest overall predictive accuracy, similar to the Cornell voltage criterion.
Similar performance to Cornell criteria does not support changing ECG screening practices; further validation studies needed before adoption.
OBJECTIVE: Many criteria have been developed to predict left ventricular hypertrophy using an electrocardiogram (ECG). However, one major common limitation of all has been their low sensitivity. Based on that, recently, a novel criterion has been proposed, which is believed to have higher sensitivity without a compromise in specificity. Therefore, in our study, we aimed to test this novel ECG criterion prospectively in large, unselected cardiac patients. METHODS: Patients who were referred to our echocardiography laboratory due to various etiologies were prospectively enrolled. The novel Peguero-Lo Presti criterion was assessed along with other established ECG criteria. The left ventricular mass index was calculated using echocardiography. The performance of each index was evaluated. RESULTS: Overall, 767 patients were enrolled in this study. The sensitivity and specificity of the Peguero-Lo Presti criterion were 17.5% and 94.5%, respectively. Although the highest sensitivity belonged to the Peguero-Lo Presti criterion, in ROC analysis, it showed modest predictive capability, which was similar to the established Cornell voltage criterion (AUC=0.64 [0.56-0.68 95% CI], p<0.01). CONCLUSION: Although this novel criterion had higher sensitivity, the overall performance was similar to the current indices. Further adjustments, particularly based on age and body mass index, may yield better results.
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Kudret Keskin (2019) conducted an observational in Left ventricular hypertrophy (n=767). Peguero-Lo Presti ECG criterion vs. Cornell voltage and Sokolow-Lyon criteria was evaluated on Predictive capability (AUC) for left ventricular hypertrophy (AUC 0.64, 95% CI 0.56-0.68, p=<0.01). The Peguero-Lo Presti ECG criterion showed 17.5% sensitivity and 94.5% specificity for detecting left ventricular hypertrophy, with a modest predictive capability (AUC 0.64) similar to Cornell criteria.
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