Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.
J Clin Hypertens (Greenwich). 2020 Jul;22(7):1145-1153. doi: 10.1111/jch.13923. Epub 2020 Jul 1.
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.
虽然心电图（ECG）是一种经济有效的常规筛查左心室肥厚（LVH）的工具，但它的性能已经被证明很差。Peguero-Lo Presti 是一种新的电压标准，被发现比最常用的标准更有潜力。我们进行了一项系统评价和荟萃分析，比较了它与 Cornell 和 Sokolow-Lyon 电压标准的诊断准确性。搜索了文献数据库以确定相关文章。进行了汇总敏感性、特异性、诊断比值比（DOR）和汇总受试者工作特征（ROC）曲线分析以进行比较。纳入了 10 项研究，这些研究共报告了 5984 个人的数据。Peguero-Lo Presti 的汇总敏感性最高（43.0%，95%置信区间 [CI]：30.2-56.9），其次是 Cornell（26.1%，95% CI：16.9-37.9）和 Sokolow Lyon（22.0%，95% CI：14.1-32.7）。然而，Peguero-Lo Presti 的汇总特异性较低（90.5%，95% CI：86.3-93.5），而 Cornell 的特异性最高（94.9%，95% CI：90.3-97.3）。汇总的 DOR 分别为 Peguero-Lo Presti（6.63，95% CI：3.95-11.13）、Cornell（5.50，95% CI：3.64-8.30）和 Sokolow-Lyon（2.94，95% CI：2.20-3.92）。根据汇总 ROC 曲线，Peguero-Lo Presti 的准确性最高，曲线下面积为 0.827，而 Cornell 为 0.715，Sokolow-Lyon 为 0.623。总之，根据这项荟萃分析，Peguero-Lo Presti 的诊断性能优于 Cornell 和 Sokolow-Lyon，作为 LVH 的筛查工具，它可能在常规临床实践中更有用。
