Key result
The Peguero-Lo Presti criterion demonstrated better diagnostic accuracy for left ventricular hypertrophy than the Cornell and Sokolow-Lyon criteria, with a pooled diagnostic odds ratio of 6.63.
Why the study?
Although ECG is cost-effective for routine LVH screening, performance has been poor; the novel Peguero-Lo Presti voltage criterion was evaluated to clarify its diagnostic accuracy against standard criteria.
Does the Peguero-Lo Presti ECG criterion improve diagnostic accuracy for left ventricular hypertrophy compared to Cornell and Sokolow-Lyon criteria?
Meta-Analysis (n=5,984)
Does the Peguero-Lo Presti ECG criterion improve diagnostic accuracy for left ventricular hypertrophy compared to Cornell and Sokolow-Lyon criteria?
Odds Ratio: 6.63 (95% CI 3.95–11.13)
Absolute Event Rate: 6.63% vs 5.5%
The Peguero-Lo Presti ECG criterion demonstrates superior overall diagnostic accuracy and sensitivity for detecting left ventricular hypertrophy compared to traditional Cornell and Sokolow-Lyon criteria.
Peguero-Lo Presti may improve ECG LVH screening sensitivity; confirms superior pooled accuracy versus Cornell and Sokolow-Lyon.
Although electrocardiography (ECG) is a cost-effective and convenient tool for routine screening of left ventricular hypertrophy (LVH), its performance has been shown to be poor. The Peguero-Lo Presti, a novel voltage criterion, was found to be potentially better than the most commonly used criteria. We conducted a systematic review and meta-analysis of its diagnostic accuracy compared to Cornell and Sokolow-Lyon voltage criteria. Bibliographic databases were searched to identify relevant articles. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (ROC) curves were performed for comparison. Ten studies reporting data from 5984 individuals were included in the meta-analysis. Peguero-Lo Presti had the highest pooled sensitivity (43.0%, 95% confidence interval [CI]: 30.2-56.9) followed by Cornell (26.1%; 95% CI: 16.9-37.9) and Sokolow Lyon (22.0%; 95% CI: 14.1-32.7). However, Peguero-Lo Presti had the lesser pooled specificity (90.5%; 95% CI: 86.3-93.5) and Cornell the highest (94.9%; 95% CI: 90.3-97.3). The pooled DOR was 6.63 (95% CI: 3.95-11.13), 5.50 (95% CI: 3.64-8.30), and 2.94 (95% CI: 2.20-3.92) for Peguero-Lo Presti, Cornell, and Sokolow-Lyon, respectively. Peguero-Lo Presti had the best accuracy according to summary ROC curves, with an area under the curve of 0.827 compared to 0.715 for Cornell, and 0.623 for Sokolow-Lyon. In conclusion, according to this meta-analysis, Peguero-Lo Presti has a better diagnostic performance than Cornell and Sokolow-Lyon and might be more useful in routine clinical practice as a screening tool for LVH.
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Noubiap et al. (2020) conducted a meta-analysis in Left ventricular hypertrophy (n=5,984). Peguero-Lo Presti criterion vs. Cornell and Sokolow-Lyon criteria was evaluated on Pooled diagnostic odds ratio (DOR 6.63, 95% CI 3.95-11.13). The Peguero-Lo Presti criterion demonstrated better diagnostic accuracy for left ventricular hypertrophy than the Cornell and Sokolow-Lyon criteria, with a pooled diagnostic odds ratio of 6.63.
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