Keskin Kudret, Ser Ozgur Selim, Dogan Gunes Melike, Cetinkal Gokhan, Yildiz Suleyman Sezai, Sigirci Serhat, Kilickesmez Kadriye
Department of Cardiology, Sisli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey.
North Clin Istanb. 2019 Jul 9;7(3):231-236. doi: 10.14744/nci.2019.00907. eCollection 2020.
Many criteria have been developed to predict left ventricular hypertrophy using an electrocardiogram (ECG). However, one major common limitation of all has been their low sensitivity. Based on that, recently, a novel criterion has been proposed, which is believed to have higher sensitivity without a compromise in specificity. Therefore, in our study, we aimed to test this novel ECG criterion prospectively in large, unselected cardiac patients.
Patients who were referred to our echocardiography laboratory due to various etiologies were prospectively enrolled. The novel Peguero-Lo Presti criterion was assessed along with other established ECG criteria. The left ventricular mass index was calculated using echocardiography. The performance of each index was evaluated.
Overall, 767 patients were enrolled in this study. The sensitivity and specificity of the Peguero-Lo Presti criterion were 17.5% and 94.5%, respectively. Although the highest sensitivity belonged to the Peguero-Lo Presti criterion, in ROC analysis, it showed modest predictive capability, which was similar to the established Cornell voltage criterion (AUC=0.64 [0.56-0.68 95% CI], p<0.01).
Although this novel criterion had higher sensitivity, the overall performance was similar to the current indices. Further adjustments, particularly based on age and body mass index, may yield better results.
已经制定了许多标准来利用心电图（ECG）预测左心室肥厚。然而，所有这些标准的一个主要共同局限性在于其低敏感性。基于此，最近提出了一种新的标准，据信该标准具有更高的敏感性且特异性不降低。因此，在我们的研究中，我们旨在对大量未经选择的心脏病患者前瞻性地测试这一新的心电图标准。
前瞻性纳入因各种病因转诊至我们超声心动图实验室的患者。评估了新的佩格罗-洛普雷斯蒂标准以及其他既定的心电图标准。使用超声心动图计算左心室质量指数。评估每个指标的性能。
总体而言，本研究共纳入767例患者。佩格罗-洛普雷斯蒂标准的敏感性和特异性分别为17.5%和94.5%。尽管佩格罗-洛普雷斯蒂标准的敏感性最高，但在ROC分析中，其预测能力一般，与既定的康奈尔电压标准相似（AUC = 0.64 [0.56 - 0.68 95% CI]，p < 0.01）。
尽管这一新标准具有更高的敏感性，但其总体性能与当前指标相似。进一步调整，特别是基于年龄和体重指数进行调整，可能会产生更好的结果。
