Assessment of Peguero Lo-Presti Criteria for Electrocardiographic Diagnosis of LVH in Indian Subjects

Patted, Suresh; Porwal, Sanjay; Ambar, Sameer; Prasad, Meraboina; Chincholi, Akshay S; Hesarur, Vishwanath; Patil, Vaibhav

doi:10.26502/fccm.92920037

Cited by 6 publications

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References 17 publications

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“…After the titles and abstracts were reviewed, 22 studies were excluded for different reasons, leaving 9 studies for careful review of the full text. After carefully reviewing the full text, 4 studies were excluded for inappropriate LVH diagnosis criteria [ 15 , 17 , 22 , 23 ], leaving 5 studies to be included [ 12 – 14 , 16 , 18 ]. One study conducted by Peguero et al had 2 different cohorts (test and validation cohorts) [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…The mean BMI of the included patients ranged from 24.80 to 31.0 kg/m 2 . Four trials reported the body surface area (BSA) [ 12 – 14 ]. The mean BSA of the included patients ranged from 1.67 to 2.05 m 2 .…”

Section: Resultsmentioning

confidence: 99%

“…According to the echocardiography results, the prevalence of LVH among studies ranged from 10.44% to 58.62% (mean 20.02%). The included studies were conducted in Egypt [ 13 ], India [ 14 ], the USA [ 12 ], Italy [ 18 ] and China [ 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two trials were cross-sectional studies [ 13 , 14 ], and the remaining 4 trials were retrospective studies [ 12 , 16 , 18 ]. Four trials reported the admitting diagnosis (coronary artery disease [ 13 ], hypertension [ 14 ], and cardiovascular disease [ 12 ]) of the included patients. The histories of heart disease and medication are recorded in S4 Table .…”

Section: Resultsmentioning

confidence: 99%

“…After carefully reading the full text of the included trials, we found that 2 trials conducted by Ricciardi et al [ 18 ] and Sun et al [ 16 ] included partly healthy subjects. After removing these 2 trials, the heterogeneity of the remaining 4 trials was small and acceptable [ 12 – 14 ].…”

Section: Resultsmentioning

confidence: 99%

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

Song

Cheng

et al. 2021

PLoS ONE

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Song

Cheng

et al. 2021

PLoS ONE

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Do We Need New Electrocardiographic Criteria for Left Ventricular Hypertrophy? The Case of the Peguero–Lo Presti Criterion. A Narrative Review

Faggiano,

Gherbesi,

Tadic

et al. 2023

American Journal of Hypertension

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The cardiovascular risk associated with left ventricular hypertrophy (LVH) in the community and, particularly, in the hypertensive fraction of the general population, represents the rationale for its timely and accurate identification in order to implement adequate preventive strategies. Although electrocardiography (ECG) is the first-line and most economical method of diagnosing LVH its accuracy is largely suboptimal. Over the last 70 years, dozens of different ECG criteria, mostly based on measurements of QRS voltages, have been proposed. In this long journey, a few years ago Peguero et al. developed a novel ECG voltage criterion, currently recognized as Peguero–Lo Presti (PLP) suggesting that it has greater sensitivity than traditional ECG-LVH criteria. Considering that in the last 5 years numerous studies have investigated the diagnostic value of this new index, this review aimed to summarize the data published so far on this topic focusing both on the accuracy in identifying the presence of LVH compared with imaging techniques such as echocardiography (ECHO) and magnetic resonance imaging (MRI) and the value in predicting hard outcomes. The evidence in favor of the greater diagnostic accuracy of the PLP criterion in detecting LVH, phenotyped by ECHO or MRI, and in the stratification of hard outcomes compared with traditional ECG criteria does not appear to be sufficiently proven. Given that the diagnosis of LVH by all ECG criteria (including the PLP) exclusively based on the QRS amplitude is largely imprecise, the development of new multiparametric ECG criteria based on artificial intelligence could represent a real improvement in the diagnostic capacity of the ECG.

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A meta‐analytic evaluation of the diagnostic accuracy of the electrocardiographic Peguero‐Lo Presti criterion for left ventricular hypertrophy

Noubiap

Agbaedeng

Nyaga³

et al. 2020

J of Clinical Hypertension

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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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Assessment of Peguero Lo-Presti Criteria for Electrocardiographic Diagnosis of LVH in Indian Subjects

Cited by 6 publications

References 17 publications

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

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

Do We Need New Electrocardiographic Criteria for Left Ventricular Hypertrophy? The Case of the Peguero–Lo Presti Criterion. A Narrative Review

A meta‐analytic evaluation of the diagnostic accuracy of the electrocardiographic Peguero‐Lo Presti criterion for left ventricular hypertrophy

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