Key result
The Peguero-Lo Presti ECG criteria diagnosed left ventricular hypertrophy in hypertensive patients with 54.8% sensitivity and 97.6% specificity, which improved to 67.1% sensitivity with modified cut-offs.
Why the study?
To evaluate the ability of Peguero-Lo Presti ECG criteria to diagnose LVH and obtain a new cut-off point in patients with hypertension at Adam Malik Hospital.
Does the Peguero-Lo Presti ECG criteria accurately diagnose left ventricular hypertrophy in patients with hypertension?
Cross-Sectional (n=115)
Blinded interpretation
No
Does the Peguero-Lo Presti ECG criteria accurately diagnose left ventricular hypertrophy in patients with hypertension?
The Peguero-Lo Presti ECG criteria, particularly with lowered amplitude cut-offs, provides high specificity and moderate sensitivity for diagnosing left ventricular hypertrophy in hypertensive patients.
Answers are grounded in this paper and cite their sources.
May support adjusted Peguero-Lo Presti thresholds for LVH screening in hypertension; hypothesis-generating and requires prospective validation.
Background: Left ventricular hypertrophy (LVH) is a preclinical manifestation of cardiovascular disease and a strong predictor of cardiovascular morbidity and mortality. The electrocardiogram (ECG) is an easily available, easy to use and cost effective tool to evaluate LVH. Peguero – Lo Presti criteria is a newcriteria to diagnose LVH from ECG that has higher sensitivity than the other ECG criteria.Aims: To assess the ability of Peguero – Lo Presti criteria to diagnose LVH and obtain new cut-off point criteria to more accurately diagnose LVH in patients with hypertension in Adam Malik Hospital.Methods: A cross sectional study was conducted on patients with hypertension in cardiac centre Adam Malik Hospital Medan. Electrocardiographic examination was performed to obtain Peguero – Lo Presti point in blinded fashion. LVH was assessed using M-mode method with Cube formula. The analysis of Peguero – Lo Presti criteria was based on the calculation of the deepest S wave in any precordial lead (deepest S wave,SD) and S wave in lead V4 (SV4). A SD + SV4 ≥ 28 mm in male and ≥ 23 mm in female subjects were considered positive for LVH. LVH was defined as left ventricular mass index > 115 gr/m2 in male and > 95 gr/m2 in female subjects.Results: Peguero – Lo Presti criteria had 54.8% sensitivity, 97.6% specificity, 55.4% NPV and 97.6% PPV to diagnose LVH. Lowering the cut-off point of Peguero – Lo Presti criteria to 26 mm in male and 22 mm in female subjects improved the sensitivity from 54.8% to 67.1% with 90.5% specificity, 61.3% NPV and 92.5% PPV to diagnose LVH.Conclusion: Peguero – Lo Presti criteria on ECG could be used to diagnose LVH in patients with hypertension in Adam Malik Hospital Medan.
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Ginting et al. (2020) conducted a cross-sectional in Hypertension (n=115). Peguero-Lo Presti ECG criteria vs. Echocardiography (reference standard) was evaluated on Diagnostic accuracy for left ventricular hypertrophy (Sensitivity 54.8%, Specificity 97.6%, p=<0.001). The Peguero-Lo Presti ECG criteria diagnosed left ventricular hypertrophy in hypertensive patients with 54.8% sensitivity and 97.6% specificity, which improved to 67.1% sensitivity with modified cut-offs.
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