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.

Background : Mitral Annular Plane Systolic Excursion (MAPSE) is a simple and easily obtained parameter. MAPSE may contribute to the evaluation of left ventricular function. In critical care settings where acoustic windows are often suboptimal, MAPSE seems to be an attractive parameter. A decreased MAPSE is known to be associated with conditions affecting left ventricular function such as myocardial infarction. The prognostic value of MAPSE in patients with ST elevation myocardial infarction (STEMI) has not been studied too much. This study aims to prove whether MAPSE can be used as a predictor of adverse cardiac events (MACE) in patients with STEMI during hospitalized in Haji Adam Malik Hospital Medan. Methods : This is a prospective cohort study of 98 patients with STEMI who undergo treatment at Haji Adam Malik Hospital Medan since July 2017 until December 2017. All patients will be examined transthoracic echocardiography to assess MAPSE in 24 hours after patients admitted at this hospital. Patients will be followed during hospitalization to assess MACE. Then conducted analysis to see association between MAPSE and MACE. Results : In the ROC curve analysis, the cutoff value of MAPSE in the prediction of MACE was 7.65 mm (AUC 0.904, 95% CI 0.836-0.972, p<0.001). The STEMI group with dengan MAPSE ≤ 7.65 mm had a higher incidence of MACE than the group with MAPSE > 7.65 mm of 35 people (83.3%) versus 7 people (16.7%). MAPSE ≤ 7.65 mm is considered to predict the incidence of MACE with a sensitivity of 83.3%, a specificity of 92.2%, a negative predictive value (NPV) of 88.1% and a positive predictive value (PPV) of 89.7%. Multivariate analysis showed that MAPSE ≤ 7.65 mm was an independent factor that could predict the occurrence of MACE during the hospitalization period (OR 1.886, 95% CI 1.21-2.94, p=0.002). Conclusion : MAPSE ≤ 7.65 mm was an independent factor that could predict the occurrence of MACE during the hospitalization in STEMI patients with OR 1.886.