Matusik Patrycja S, Bryll Amira, Pac Agnieszka, Popiela Tadeusz J, Matusik Paweł T
Department of Diagnostic Imaging, University Hospital, 30-688 Kraków, Poland.
Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Kraków, Poland.
J Clin Med. 2022 Jun 22;11(13):3585. doi: 10.3390/jcm11133585.
Left ventricular hypertrophy (LVH) is associated with adverse clinical outcomes and implicates clinical decision-making. The aim of our study was to assess the importance of different approaches in the screening for LVH. We included patients who underwent cardiac magnetic resonance (CMR) imaging and had available chest radiograph in medical documentation. Cardiothoracic ratio (CTR), transverse cardiac diameter (TCD), clinical and selected electrocardiographic (ECG)-LVH data, including the Peguero-Lo Presti criterion, were assessed. CMR−LVH was defined based on indexed left ventricular mass-to-body surface area. Receiver operating characteristics analyses showed that both the CTR and TCD (CTR: area under the curve: [AUC] = 0.857, p < 0.001; TCD: AUC = 0.788, p = 0.001) were predictors for CMR−LVH. However, analyses have shown that diagnoses made with TCD, but not CTR, were consistent with CMR−LVH. From the analyzed ECG−LVH criteria, the Peguero-Lo Presti criterion was the best predictor of LVH. The best sensitivity for screening for LVH was observed when the presence of heart failure, ≥40 years in age (each is assigned 1 point), increased TCD and positive Peguero-Lo Presti criterion (each is assigned 2 points) were combined (CAR2E2 score ≥ 3 points). CAR2E2 score may improve prediction of LVH compared to other approaches. Therefore, it may be useful in the screening for LVH in everyday clinical practice in patients with prevalent cardiovascular diseases.
左心室肥厚（LVH）与不良临床结局相关，并涉及临床决策。我们研究的目的是评估不同方法在LVH筛查中的重要性。我们纳入了接受心脏磁共振（CMR）成像且在医疗记录中有可用胸部X线片的患者。评估了心胸比率（CTR）、心脏横径（TCD）、临床及选定的心电图（ECG）-LVH数据，包括佩格罗-洛普雷斯蒂标准。CMR-LVH根据左心室质量指数与体表面积来定义。受试者工作特征分析表明，CTR和TCD均为CMR-LVH的预测指标（CTR：曲线下面积：[AUC]=0.857，p<0.001；TCD：AUC=0.788，p=0.001）。然而，分析表明，基于TCD而非CTR做出的诊断与CMR-LVH一致。在所分析的ECG-LVH标准中，佩格罗-洛普雷斯蒂标准是LVH的最佳预测指标。当合并存在心力衰竭、年龄≥40岁（每项计1分）、TCD增加及佩格罗-洛普雷斯蒂标准阳性（每项计2分）时（CAR2E2评分≥3分），观察到LVH筛查的最佳敏感性。与其他方法相比，CAR2E2评分可能改善LVH的预测。因此，它可能有助于在患有常见心血管疾病的患者日常临床实践中进行LVH筛查。
