Luangphiphat Wongsakorn, Phaisitkriengkrai Atthaphon, Methavigul Ratikorn, Methavigul Komsing
Department of Cardiology, Central Chest Institute of Thailand, Nonthaburi 11000, Thailand.
Asian Biomed (Res Rev News). 2021 Apr 30;15(2):101-107. doi: 10.2478/abm-2021-0012. eCollection 2021 Apr.
Several electrocardiographic (ECG) criteria are used to diagnose left ventricular hypertrophy (LVH); however, they have low sensitivity.
To assess the sensitivity of LVH diagnosis using Peguero-Lo Presti criteria modified by body surface area (BSA).
This study used retrospective data from 9,438 patients who attended the Central Chest Institute of Thailand from January 2017 to December 2017 with available echocardiography, and who were categorized into those with and without LVH to determine diagnostic accuracy. We randomly selected 317 patients after excluding others based on various conditions. The left ventricular mass of the 317 patients was estimated using echocardiography. Peguero-Lo Presti criteria were modified by dividing original criteria by BSA. The accuracy of the modified criteria was compared with that of the original Peguero-Lo Presti, Sokolow-Lyon, and Cornell voltage criteria. A McNemar test was used to determine the agreement of all ECG criteria examined with LV mass index. The area under a receiver operating characteristic curve (AUC) was used to assess the performance of the criteria.
LVH was diagnosed in 164 of the 317 patients using echocardiography. The sensitivity of modified Peguero-Lo Presti criteria was 50.6% (95% confidence interval [CI] 42.7% to 58.5%), and specificity was 88.2% (95% CI 82.0% to 92.9%), with an AUC of 0.67 (95% CI 0.61-0.73).
Peguero-Lo Presti criteria modified by dividing them by BSA can improve sensitivity with acceptable specificity for the diagnosis of LVH compared with other ECG criteria examined, at least in selected Thai patients. The modified Peguero-Lo Presti criteria have accuracy similar to that for the original criteria.
有多种心电图（ECG）标准用于诊断左心室肥厚（LVH）；然而，它们的敏感性较低。
评估经体表面积（BSA）修正的佩格罗-洛普雷斯蒂标准对LVH诊断的敏感性。
本研究使用了泰国中央胸科研究所2017年1月至2017年12月期间9438例患者的回顾性数据，这些患者均有可用的超声心动图检查结果，并被分为有LVH和无LVH两组以确定诊断准确性。在根据各种条件排除其他患者后，我们随机选择了317例患者。使用超声心动图估计这317例患者的左心室质量。佩格罗-洛普雷斯蒂标准通过将原始标准除以BSA进行修正。将修正后的标准的准确性与原始佩格罗-洛普雷斯蒂、索科洛-里昂和康奈尔电压标准的准确性进行比较。使用麦克尼马尔检验来确定所有检查的ECG标准与左心室质量指数的一致性。使用受试者工作特征曲线（AUC）下的面积来评估这些标准的性能。
在317例患者中，通过超声心动图诊断出164例LVH。修正后的佩格罗-洛普雷斯蒂标准的敏感性为50.6%（95%置信区间[CI]42.7%至58.5%），特异性为88.2%（95%CI 82.0%至92.9%），AUC为0.67（95%CI 0.61 - 0.73）。
与所检查的其他ECG标准相比，经BSA修正的佩格罗-洛普雷斯蒂标准在诊断LVH时可提高敏感性，并具有可接受的特异性，至少在选定的泰国患者中如此。修正后的佩格罗-洛普雷斯蒂标准的准确性与原始标准相似。
