Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia.
Department of Cardiology, Centro Hospitalar Universitário do Algarve, Portugal.
J Cardiovasc Med (Hagerstown). 2020 Jun;21(6):437-443. doi: 10.2459/JCM.0000000000000964.
The diagnostic performance of the new Peguero-Lo Presti ECG criteria for left ventricular hypertrophy (LVH) has not been validated by cardiac magnetic resonance (CMR). The aim of this study was to evaluate and compare the diagnostic performance of Peguero-Lo Presti, Cornell and Sokolow--Lyon voltage criteria for LVH as defined by CMR in an all-comers European population.
A total of 240 consecutive patients referred for CMR who had a concomitant electrocardiogram for review were evaluated. LVH group patients were defined according to the reference values for sex and age of left ventricular mass index (LVMi). A control group, adjusted by sex, was randomly selected from a population without LVH. We applied the ECG voltage criteria to both groups and evaluated their diagnostic accuracy. Diagnostic sensitivity and specificity were compared.
Two hundred and forty patients (mean age 63 years; 65% men) were divided into two groups (LVH n = 149; control n = 91). The main causes of LVH were hypertension (24.8%) and hypertrophic cardiomyopathy (21.5%). The remaining patients of this group had a diagnosis of dilated cardiomyopathy (14.8%), valvular heart disease (7.4%) and infiltrative cardiomyopathy (2.0%). Overall, the sensitivity for LVH diagnosis of the Peguero-Lo Presti criteria outperformed both the Cornell (47 vs. 29%, P < 0.001) and Sokolow--Lyon voltage criteria (vs. 25%, P < 0.001). The specificities of all the criteria were above 94%, without significant differences between them.
In an all-comers European population with LVH defined by CMR, the criteria of Peguero-Lo Presti showed increased sensitivity for this diagnosis, when compared with the Sokolow--Lyon and Cornell voltage criteria. As such, they could become the preferred ECG diagnostic tool when evaluating patients at risk for LVH.
新的佩格罗-洛·普雷斯蒂心电图（ECG）标准诊断左心室肥厚（LVH）的性能尚未通过心脏磁共振（CMR）验证。本研究旨在评估和比较佩格罗-洛·普雷斯蒂、康奈尔和索科洛夫-里昂电压标准在欧洲所有患者人群中作为 CMR 定义的 LVH 的诊断性能。
共评估了 240 例连续因 CMR 就诊且同时有心电图可供回顾的患者。LVH 组患者根据左心室质量指数（LVMi）的性别和年龄参考值定义。从无 LVH 的人群中随机选择性别匹配的对照组。我们将 ECG 电压标准应用于两组，并评估其诊断准确性。比较诊断敏感性和特异性。
240 例患者（平均年龄 63 岁，65%为男性）分为两组（LVH 组 n=149，对照组 n=91）。LVH 的主要病因是高血压（24.8%）和肥厚型心肌病（21.5%）。该组其余患者的诊断为扩张型心肌病（14.8%）、瓣膜性心脏病（7.4%）和浸润性心肌病（2.0%）。总体而言，Peguero-Lo Presti 标准对 LVH 的诊断敏感性优于 Cornell（47%比 29%，P<0.001）和 Sokolow-Lyon 电压标准（比 25%，P<0.001）。所有标准的特异性均高于 94%，之间无显著差异。
在 CMR 定义的 LVH 的所有患者欧洲人群中，与 Sokolow-Lyon 和 Cornell 电压标准相比，Peguero-Lo Presti 标准对该诊断的敏感性更高。因此，在评估 LVH 风险患者时，它们可能成为首选的 ECG 诊断工具。
