Peguero-Lo Presti criteria for the diagnosis of left ventricular hypertrophy: A systematic review and meta-analysis

Abstract

Background The Peguero-Lo Presti criteria are novel electrocardiographic (ECG) diagnostic criteria for the detection of left ventricular hypertrophy (LVH) and represent the sum of the amplitude of the deepest S wave in any lead with the S wave in lead V4 (SD+SV4). The diagnostic efficacy of the Peguero-Lo Presti criteria in LVH is still debatable. We aimed to test the sensitivity and specificity of the Peguero-Lo Presti criteria and compared them with those of the Cornell voltage index to assess their overall performance in LVH diagnosis. Methods Electronic databases (e.g., Medline, Web of Knowledge, Embase, and the Cochrane Library) were searched from their inception until May 18, 2020. Trials written in English that investigated the Peguero-Lo Presti criteria for detecting LVH were included. Data were independently extracted and analyzed by two investigators. Results A total of 51 records were screened, and 6 trials comprising 13,564 patients were finally included. A bivariate analysis showed that the sensitivity of the Peguero-Lo Presti criteria (0.52, 95% confidence interval (CI) 0.46–0.58) was higher than that of the Cornell voltage index (0.29, 95% CI 0.23–0.36) and Sokolow-Lyon criteria (0.24, 95% CI 0.21–0.27); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.69, 95% CI 0.65–0.73) was also higher than that of the Cornell voltage index (0.67, 95% CI 0.62–0.71) and Sokolow-Lyon criteria (0.28, 95% CI 0.25–0.32); and the specificity of the Peguero-Lo Presti criteria (0.85, 95% CI 0.79–0.90) was similar to that of the Cornell voltage index (0.92, 95% CI 0.89–0.95) and Sokolow-Lyon criteria (0.94, 95%CI 0.88–0.97). Two trials (including 12,748 patients) were discharged because they included partly healthy subjects and accounted for substantial heterogeneity. Pooled analysis of the remaining 4 trials (including 816 patients) showed that the sensitivity of the Peguero-Lo Presti criteria (0.56, 95% CI 0.51–0.61) was also higher than that of the Cornell voltage index (0.36, 95% CI 0.31–0.42) and Sokolow-Lyon criteria (0.24, 95% CI 0.18–0.31); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.84, 95% CI 0.80–0.87) was also higher than that of the Cornell voltage index (0.54, 95% CI 0.50–0.58) and Sokolow-Lyon criteria (0.38, 95% CI 0.34–0.42); and the specificity of the Peguero-Lo Presti criteria (0.90, 95% CI 0.87–0.92) was similar to that of the Cornell voltage index (0.93, 95% CI 0.88–0.96) and Sokolow-Lyon criteria (0.97, 95% CI 0.90–0.99). Both the likelihood ratio and posttest probability of the Peguero-Lo Presti criteria and Cornell voltage index were moderate. Conclusion Based on this systematic review and meta-analysis, the Peguero-Lo Presti criteria-based ECG diagnostic method for LVH has high sensitivity, specificity and diagnostic accuracy and should be applied in clinical practice settings.

Evaluation of Different Criteria in the Diagnosis of Left Ventricular Hypertrophy by Electrocardiogram in Comparison With Echocardiogram

“…Furthermore, in the literature, the comparison between the ECG and the ECHO is a common methodology for the evaluation of electrocardiographic criteria in the diagnosis of LVH. Since the publication of the Peguero-Lo Presti criterion, several studies have been carried out in this way in order to evaluate its performance, including a meta-analysis, whose results were similar to those found in our work [19][20][21][22][23][24][25][26][27].…”

“…Regarding specificity, this criterion obtained a performance of 82.1%. In the meta-analysis by Yu et al, which covered five studies, the sensitivity found for the Peguero-Lo Presti criterion was 52%, while the specificity was 85% [ 20 ]. The results of both studies were similar to the findings for eccentric LVH in our study.…”

New Genetic finding in a Combination of Long QT Syndrome and Hypertrophic Cardiomyopathy in a Single Patient

“…Hypertrophic cardiomyopathy is electrocardiographically characterised by left ventricular hypertrophy measured by SOKOLOW-LYON-index above 3.5 mV [2] or LEWIS-index above 1.6 mV [3], Cornell criteria above 2,0 mV for females and above 2,8 mV for males [4], Peguero-LoPresti ECG criteria above 2.3 mV for females and 2,8 mV for males [5], right ventricular SOKOLOW-LYON-index [6], signs of biventricular hypertrophy criteria [7] and pathologic Q-waves and T-wave inversions [8] Echocardiographically, HCM is characterised by asymmetrical left and right ventricular hypertrophy and usually with abnormalities of mitral valve with leaflet elongation, chordae and papillary muscle abnormalities enhancing left ventricular outflow tract obstruction as demonstrated in the three patients of this family.…”

Hubungan Hipertrofi Ventrikel Kiri pada Elektrokardiogram Peguero-Lo Presti Dengan Ekokardiografi pada Hipertensi

“…7 Alat diagnostik yang luas tersedia, bersifat non invasif, mempunyai biaya yang rendah serta yang umum digunakan untuk mendiagnosis hipertrofi Salsa Oktarin Letmi 61 ventrikel kiri adalah elektrokardiografi (EKG). 7,10,13 Terdapat kriteria dalam mendiagnosis hipertrofi ventrikel kiri melalui pemeriksaan EKG seperti Voltase Sokolow-Lyon dan Voltase Cornell. 14 Sensitivitas EKG dalam mendiagnosis umumnya masih rendah.…”