Cao Yiwei, Liang Lei, Yao Xiaowei, Shou Xiling, Cheng Gong, Fu Jianli, Wu Haoyu
Department of Electrocardiology, Shaanxi Provincial People's Hospital, 710068 Xi'an, Shaanxi, China.
Department of Cardiology, Shaanxi Provincial People's Hospital, 710068 Xi'an, Shaanxi, China.
Rev Cardiovasc Med. 2022 Sep 16;23(9):319. doi: 10.31083/j.rcm2309319. eCollection 2022 Sep.
The classic electrocardiogram (ECG) criteria have been applied to left ventricular hypertrophy (LVH) screening but have low sensitivity. Recently, the newly proposed Peguero-Lo Presti criterion has been proven to be more sensitive in detecting LVH in patients with hypertension than several current ECG criteria. The diagnostic value of the Peguero-Lo Presti criterion in hypertrophic cardiomyopathy (HCM) patients has not been fully evaluated. This study aims to test whether the new Peguero-Lo Presti criterion can improve the diagnostic performance in patients with HCM.
This study included HCM patients and sex-and age-matched healthy control subjects. The diagnostic performance of the Peguero-Lo Presti criterion was evaluated along with the Sokolow-Lyon criterion, Cornell criterion, and total 12-lead voltage criterion.
Overall, 63 HCM patients and 63 controls were enrolled. The diagnostic accuracy, sensitivity and specificity of Peguero-Lo Presti criterion were 74.6%, 73.0% and 76.2%, respectively. The Peguero-Lo Presti criterion had the highest sensitivity, while the Cornell criterion and Sokolow-Lyon criterion had the highest specificity (96.8%). The area under the curve (AUC) showed that the Peguero-Lo Presti criterion was 0.809 (95% CI, 0.730-0.874; 0.0001), Sokolow-Lyon criterion was 0.841 (95% CI, 0.766-0.900) and total 12-lead voltage criterion was 0.814 (95% CI, 0.735-0.878). There was no significant difference in AUC between Peguero-Lo Presti criterion and Sokolow-Lyon criterion ( 0.533), or Peguero-Lo Presti criterion and total 12-lead voltage criterion ( 0.908). Receiver operator characteristic curve analysis of the Peguero-Lo Presti criterion showed an optimal cutoff of 3.15 mV for men (sensitivity: 63.9%; specificity: 80.0%) and 2.29 mV for women (sensitivity: 78.6%; specificity: 85.7%).
The Peguero-Lo Presti criterion provides high sensitivity for ECG diagnosis of HCM patients and can be considered when applicable but this needs to be verified in a larger population.
经典心电图（ECG）标准已应用于左心室肥厚（LVH）筛查，但敏感性较低。最近，新提出的佩格罗 - 洛·普雷斯蒂标准已被证明在检测高血压患者的LVH方面比目前的几种ECG标准更敏感。佩格罗 - 洛·普雷斯蒂标准在肥厚型心肌病（HCM）患者中的诊断价值尚未得到充分评估。本研究旨在测试新的佩格罗 - 洛·普雷斯蒂标准是否能提高HCM患者的诊断性能。
本研究纳入了HCM患者以及性别和年龄匹配的健康对照者。对佩格罗 - 洛·普雷斯蒂标准以及索科洛 - 里昂标准、康奈尔标准和12导联总电压标准的诊断性能进行了评估。
总体而言，共纳入了63例HCM患者和63例对照者。佩格罗 - 洛·普雷斯蒂标准的诊断准确性、敏感性和特异性分别为74.6%、73.0%和76.2%。佩格罗 - 洛·普雷斯蒂标准的敏感性最高，而康奈尔标准和索科洛 - 里昂标准的特异性最高（96.8%）。曲线下面积（AUC）显示，佩格罗 - 洛·普雷斯蒂标准为0.809（95%CI，0.730 - 0.874；P < 0.0001），索科洛 - 里昂标准为0.841（95%CI，0.766 - 0.900），12导联总电压标准为0.814（95%CI，0.735 - 0.878）。佩格罗 - 洛·普雷斯蒂标准与索科洛 - 里昂标准之间的AUC无显著差异（P = 0.533），佩格罗 - 洛·普雷斯蒂标准与12导联总电压标准之间也无显著差异（P = 0.908）。佩格罗 - 洛·普雷斯蒂标准的受试者工作特征曲线分析显示，男性的最佳截断值为3.15 mV（敏感性：63.9%；特异性：80.0%），女性为2.29 mV（敏感性：78.6%；特异性：85.7%）。
佩格罗 - 洛·普雷斯蒂标准对HCM患者的心电图诊断具有较高的敏感性，在适用时可予以考虑，但这需要在更大规模的人群中进行验证。
