Electrocardiographic Criteria for the Diagnosis of Left Ventricular Hypertrophy

Betjeman, Thomas J.; Rigales, Luis; Hoffman, Irwin

doi:10.1016/j.jacc.2017.05.085

Journal of the American College of Cardiology

2017

DOI: 10.1016/j.jacc.2017.05.085

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Electrocardiographic Criteria for the Diagnosis of Left Ventricular Hypertrophy

Thomas J. Betjeman¹,

Luis Rigales²,

Irwin Hoffman³

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“…Jiang et al reported a significantly lower sensitivity of SD+SV4 criteria than the previous studies . We believe that the main reason for this low sensitivity is low prevalence of LVH and obesity in the study population.…”

contrasting

confidence: 52%

“…Peguero et al first introduced this ECG criterion for LVH and reported that its sensitivity of 62% was significantly higher than the sensitivity for the Cornell criteria (only 35%) in a small population (n = 94) which consisted of hypertensive and non‐hypertensive patients . The specificity in both criteria was higher than 90% and did not significantly differ . Chao et al involved more hypertensive patients (n = 235) and confirmed superiority of the new ECG criterion for LVH over the traditional Cornell criteria .…”

mentioning

confidence: 96%

“…Previous studies considered that the Cornell voltage criteria had the best accuracy with the specificity of 90% and the sensitivity of only 20%‐40% . However, recently, several studies showed that SD+SV4, a new ECG criterion for LVH diagnosis, had a significantly higher sensitivity than the Cornell voltage criteria . Peguero et al first introduced this ECG criterion for LVH and reported that its sensitivity of 62% was significantly higher than the sensitivity for the Cornell criteria (only 35%) in a small population (n = 94) which consisted of hypertensive and non‐hypertensive patients .…”

mentioning

confidence: 99%

“…However, recently, several studies showed that SD+SV4, a new ECG criterion for LVH diagnosis, had a significantly higher sensitivity than the Cornell voltage criteria . Peguero et al first introduced this ECG criterion for LVH and reported that its sensitivity of 62% was significantly higher than the sensitivity for the Cornell criteria (only 35%) in a small population (n = 94) which consisted of hypertensive and non‐hypertensive patients . The specificity in both criteria was higher than 90% and did not significantly differ .…”

mentioning

confidence: 99%

“…The new ECG criterion, which involves measuring the amplitude of the deepest S wave in any single lead and adding it to the S‐wave amplitude of lead V4, seems to have significantly better accuracy than previous ECG criteria. Peguero et al who introduced this parameter suggested that the reason for better sensitivity lies in electrophysiology and conducting of impulse in patients with LVH . Namely, the majority of ECG criteria for LVH are focused on R wave in different leads, whereas their study showed that S wave was more strongly related with LV mass.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Electrocardiographic criteria for cardiac remodeling in hypertensive patients

Tadić

Cuspidi

2019

J of Clinical Hypertension

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contrasting

confidence: 52%

mentioning

confidence: 96%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Electrocardiographic criteria for cardiac remodeling in hypertensive patients

Tadić

Cuspidi

2019

J of Clinical Hypertension

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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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<p>Consistency of left ventricular hypertrophy diagnosed by electrocardiography and echocardiography: the Northern Shanghai Study</p>

Zhang

Zhou

Bai

et al. 2019

CIA

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BackgroundLeft ventricular hypertrophy (LVH) is one of the preclinical manifestations of hypertensive target organ damage (TOD). However, it remains unclear which electrocardiographic criterion perform better in diagnosing LVH.PurposeTo investigate the consistency of LVH diagnosed by electrocardiography (ECG) and echocardiography (ECHO). Taking LVH by ECHO as reference, to compare three different ECG criteria (Sokolow-Lyon, Cornell and Cornell Product criteria) and find the best ECG indicator for identifying LVH in community-based elderly Chinese.Patients and methodsEchocardiography and electrocardiography were applied to define LVH in 1789 elderly Chinese aged >65 years old in communities located at the northern Shanghai. Echocardiographic LVH (ECHO-LVH) was defined by left ventricular mass indexed for Body Surface Area (LVM/BSA) or for height2.7 (LVM/height2.7). Electrocardiographic LVH (ECG-LVH) was defined by Sokolow-Lyon (SL), Cornell and Cornell Product (CP) criteria. ECHO-LVH was defined by LVM/BSA≥125 g/m2 in male or ≥110 g/m2 in female (LVH1); LVM/BSA≥115 g/m2 in male, or ≥95 g/m2 in female (LVH2) and LVM/height2.7 ≥51 g/m2.7 in male or ≥47 g/m2.7 in female (LVH3).ResultsAs compared with SL and Cornell criteria, CP had the greatest correlation coefficient in the association with echocardiography-defined LVH, except for LVM/BSA in men. Of note, CP criterion had the greatest area under curve of ROC than Cornell criterion and the SL index, not only in total population but also in subgroups classified by blood pressure.ConclusionIn ECG-LVH criteria, CP criterion complies better than SL index and Cornell criterion in assessing cardiac hypertrophy.

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Electrocardiographic Criteria for the Diagnosis of Left Ventricular Hypertrophy

Cited by 3 publications

References 3 publications

Electrocardiographic criteria for cardiac remodeling in hypertensive patients

Electrocardiographic criteria for cardiac remodeling in hypertensive patients

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

<p>Consistency of left ventricular hypertrophy diagnosed by electrocardiography and echocardiography: the Northern Shanghai Study</p>

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