scholarly journals Diagnostic Accuracy of the Electrocardiography Criteria for Left Ventricular Hypertrophy (Cornell Voltage Criteria, Sokolow-Lyon Index, Romhilt-Estes, and Peguero-Lo Presti Criteria) Compared to Transthoracic Echocardiography

Cureus ◽  
2021 ◽  
Author(s):  
Nurseli Bayram ◽  
Haldun Akoğlu ◽  
Erkman Sanri ◽  
Sinan Karacabey ◽  
Melis Efeoğlu ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diagnostic Accuracy ◽  
Transthoracic Echocardiography ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Cornell Voltage

scholarly journals Peguero-Lo Presti criteria for the diagnosis of left ventricular hypertrophy: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246305
Author(s):  
Zongying Yu ◽  
Jie Song ◽  
Li Cheng ◽  
Shasha Li ◽  
Qun Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Left Ventricular Hypertrophy ◽  
Diagnostic Accuracy ◽  
Ventricular Hypertrophy ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Cochrane Library ◽  
Bivariate Analysis ◽  
S Wave ◽  
Cornell Voltage

Background The Peguero-Lo Presti criteria are novel electrocardiographic (ECG) diagnostic criteria for the detection of left ventricular hypertrophy (LVH) and represent the sum of the amplitude of the deepest S wave in any lead with the S wave in lead V4 (SD+SV4). The diagnostic efficacy of the Peguero-Lo Presti criteria in LVH is still debatable. We aimed to test the sensitivity and specificity of the Peguero-Lo Presti criteria and compared them with those of the Cornell voltage index to assess their overall performance in LVH diagnosis. Methods Electronic databases (e.g., Medline, Web of Knowledge, Embase, and the Cochrane Library) were searched from their inception until May 18, 2020. Trials written in English that investigated the Peguero-Lo Presti criteria for detecting LVH were included. Data were independently extracted and analyzed by two investigators. Results A total of 51 records were screened, and 6 trials comprising 13,564 patients were finally included. A bivariate analysis showed that the sensitivity of the Peguero-Lo Presti criteria (0.52, 95% confidence interval (CI) 0.46–0.58) was higher than that of the Cornell voltage index (0.29, 95% CI 0.23–0.36) and Sokolow-Lyon criteria (0.24, 95% CI 0.21–0.27); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.69, 95% CI 0.65–0.73) was also higher than that of the Cornell voltage index (0.67, 95% CI 0.62–0.71) and Sokolow-Lyon criteria (0.28, 95% CI 0.25–0.32); and the specificity of the Peguero-Lo Presti criteria (0.85, 95% CI 0.79–0.90) was similar to that of the Cornell voltage index (0.92, 95% CI 0.89–0.95) and Sokolow-Lyon criteria (0.94, 95%CI 0.88–0.97). Two trials (including 12,748 patients) were discharged because they included partly healthy subjects and accounted for substantial heterogeneity. Pooled analysis of the remaining 4 trials (including 816 patients) showed that the sensitivity of the Peguero-Lo Presti criteria (0.56, 95% CI 0.51–0.61) was also higher than that of the Cornell voltage index (0.36, 95% CI 0.31–0.42) and Sokolow-Lyon criteria (0.24, 95% CI 0.18–0.31); the diagnostic accuracy of the Peguero-Lo Presti criteria (0.84, 95% CI 0.80–0.87) was also higher than that of the Cornell voltage index (0.54, 95% CI 0.50–0.58) and Sokolow-Lyon criteria (0.38, 95% CI 0.34–0.42); and the specificity of the Peguero-Lo Presti criteria (0.90, 95% CI 0.87–0.92) was similar to that of the Cornell voltage index (0.93, 95% CI 0.88–0.96) and Sokolow-Lyon criteria (0.97, 95% CI 0.90–0.99). Both the likelihood ratio and posttest probability of the Peguero-Lo Presti criteria and Cornell voltage index were moderate. Conclusion Based on this systematic review and meta-analysis, the Peguero-Lo Presti criteria-based ECG diagnostic method for LVH has high sensitivity, specificity and diagnostic accuracy and should be applied in clinical practice settings.

Cornell voltage left ventricular hypertrophy predicts all-cause mortality better than Sokolow-Lyon voltage in patients with and without diabetes – data from 183,749 primary care ECGs

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Haxha ◽  
U Pedersen-Bjergaard ◽  
J.B Nielsen ◽  
J Pallisgaard ◽  
R.B Devereux ◽  
...  
Keyword(s):  
Primary Care ◽  
Left Ventricular Hypertrophy ◽  
Predictive Value ◽  
Ventricular Hypertrophy ◽  
Strong Predictor ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Type I ◽  
All Cause Mortality ◽  
Cornell Voltage

Abstract Background Cornell voltage criteria (CL) and Sokolow-Lyon criteria (SL) for electrocardiographic left ventricular hypertrophy (ECG-LVH) are well known predictors of cardiovascular outcome. However, their predictive value may differ according to patient type and remains to be further tested in diabetic mellitus (DM) patients. Purpose The present study aims to determine the prevalence of each ECG-LVH criteria and their respective predictive value in DM patients. Method A retrospective cohort study of individuals age >40 years with digital ECGs from primary care were collected during 2001 to 2011. Data on medication, comorbidity, and outcomes were collected from Danish nationwide registries. DM was defined if individuals were prescribed oral antidiabetics or insulin, if they were diagnosed with DM type I or II, or had a HbA1c>48 mmol/l. Cox multivariable analysis was used for estimating hazard ratio (HR) and 95% confidence intervals (95% CI) for all-cause mortality during follow-up of up to 17 years. Results Included were 183,749 individuals with a digital ECG collected in primary care. A total of 13,003 (7.1%) individuals had DM, they were older (65.8 vs. 61.3 years), had more myocardial infarction (16.1% vs. 5.2%), stroke (14.4% vs. 6.2%), hypertension (35.1% vs. 13.2%), CL LVH (8.0% vs. 5.6%) and more were males (53.3% vs. 45.3%) compared to the non-DM individuals (all p<0.001). CL identified a larger percentage of LVH in DM compared to non-DM individuals (8.0% vs. 5.6%, p<0.001), whereas SL identified similar percentage LVH in DM and non-DM individuals (8.5% vs. 8.1%, p=0.068). In multivariable adjusted analysis CL LVH remained strongly associated with all-cause mortality [HR 1.45 (95% CI: 1.42–1.48)] compared to SL LVH which found only a modest association [HR 1.06 (95% CI: 1.03–1.10)] (Figure 1). Of note, the association of CL LVH and all-cause mortality was even stronger than DM per se. There was no interaction with DM and either ECG LVH criteria (p>0.45). Conclusion Cornell Voltage Left Ventricular Hypertrophy is a strong predictor of mortality in patients with and without diabetes and an independent risk factor compared to hypertension and diabetes. The predictive value was substantially stronger than Sokolow-Lyon Voltage criteria for hypertrophy. Figure 1. LVH and all-cause mortality Funding Acknowledgement Type of funding source: None

The Peguero-Lo Presti criteria has the highest diagnostic accuracy for the diagnosis of left ventricular hypertrophy in the elderly

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.A.M Tavares ◽  
N Samesima ◽  
L.A Hajjar ◽  
L.C Godoy ◽  
E.M.P Hirano ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Diagnostic Accuracy ◽  
Ventricular Hypertrophy ◽  
The Elderly ◽  
Left Ventricular ◽  
Accuracy Score ◽  
Increased Sensitivity ◽  
Low Sensitivity ◽  
Ecg Criteria ◽  
Improved Accuracy

Abstract Background Left Ventricular Hypertrophy (LVH) is an independent predictor of mortality and cardiovascular morbidity and the 12-lead ECG is recommended as a universal screening for patients with hypertension. However, the ECG has low sensitivity and there is limited data in patients 70 years or older. The recently published Peguero-Lo Presti (PLP) criteria had improved accuracy compared with other ECG criteria but with very few patients with age ≥70 years included. Purpose To compare the accuracy of the PLP criteria versus the traditional ECG criteria for detecting LVH in patients ≥70 years. Methods Retrospective single-center study. Patients were included if they were 70 years or older and underwent an ECG and echocardiogram (gold standard) less than 180 days apart from jan/2017 to mar/2018. Patients with left or right bundle branch block, non-sinus rhythm or ventricular paced rhythm were excluded. All tracings were independently reviewed by two cardiologists, blinded to the echocardiogram. The PLP criteria was compared against Cornell voltage (CV), Sokolow-Lyon voltage (SL), and Romhilt-Estes 4 and 5 (RE) criteria. LVH was defined as a left ventricular mass index >115 g/m2 in males and >95 g/m2 in females, according to the echocardiogram. McNemar's test, F1 score, and the area under the Receiver Operating Characteristic curves (AUC) were used to compare the diagnostic performance of the tests Results A total of 592 patients were included (mean age 77.5 years, SD: 5.9; 50.8% were women). The PLP criteria had increased sensitivity compared with both the SL and CV criteria (p<0.0001 for both comparisons) and RE5 (p=0.042). PLP also had better specificity than the RE4 criteria (p<0.0001) and the highest F1 accuracy score (Table 1). The AUC of the PLP was significantly higher than the AUC of the CV and RE criteria (0.70 vs 0.66 vs 0.64, respectively, p<0.05) and numerically higher than the SL criteria (AUC=0.67, p=0.311, Figure 1). Conclusion Compared to the traditional ECG criteria for LVH, the PLP criteria had the highest diagnostic accuracy in elderly patients. Figure 1. AUC of the ECG criteira Funding Acknowledgement Type of funding source: None

scholarly journals Performance of Electrocardiographic Criteria for Echocardiographically Diagnosed Left Ventricular Hypertrophy in Chinese Hypertensive Patients

2020 ◽  
Vol 33 (9) ◽  
pp. 831-836 ◽  
Author(s):  
Dian Wang ◽  
Jian-Zhong Xu ◽  
Wei Zhang ◽  
Yi Chen ◽  
Jian Li ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
High Specificity ◽  
Left Ventricular ◽  
Hypertensive Patients ◽  
Receiver Operating Characteristic Curves ◽  
Low Sensitivity ◽  
Ecg Criteria ◽  
Cornell Voltage ◽  
Cornell Product

Abstract BACKGROUND Performance of electrocardiographic (ECG) criteria for echocardiographically diagnosed left ventricular hypertrophy (LVH) in Chinese hypertensive patients is not well known. We investigated the accuracy of various ECG criteria for the diagnosis of the echocardiographic LVH according to the new cutoff values of left ventricular mass (LVM) index (>115 g/m2 for men and >95 g/m2 for women) in Chinese hypertensive patients. METHODS Our study included 702 consecutive hypertensive inpatients including 92 (13.1%) concentric and 121 (17.2%) eccentric LVH on standard echocardiography. Diagnostic accuracy of 7 ECG criteria was evaluated by calculating sensitivity and specificity and by using the receiver operating characteristic curves. RESULTS The ECG criteria for the detection of the echocardiographically defined LVH had a sensitivity of 15%–31.9% and specificity of 91.6%–99.2% overall, 20.7%–43.5% and 91.6%–99.2% concentric, and 7.4%–23.1% and 91.6%–99.2% eccentric. ECG diagnosis of LVH defined as the positive diagnosis of any of 4 ECG criteria including Sokolow–Lyon voltage, Cornell voltage, Cornell product, and RavL voltage had a sensitivity of 54% and specificity of 86.3% overall, 71.7% and 86.3% concentric, and 40.5% and 86.3% eccentric. After adjustment for confounding factors, various ECG criteria were significantly correlated with LVM, with standardized β coefficients from 0.20 to 0.39 (P < 0.001) and the highest coefficient for the Cornell product criterion. CONCLUSIONS All ECG LVH indexes had low sensitivity and high specificity in Chinese hypertensive patients. Combination of 4 or all ECG criteria might improve sensitivity without any loss of specificity.

Abstract P253: Genome-Wide Association Study of Electrocardiographic Left Ventricular Hypertrophy among Persons of European Ancestry: the Kaiser Permanente/UCSF GERA Cohort

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Carlos Iribarren ◽  
Ling Shen ◽  
Alfred D Round ◽  
Edward McNulty ◽  
Peter M Okin ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Genome Wide Association Study ◽  
Left Ventricular ◽  
Genome Wide Association ◽  
European Ancestry ◽  
Kaiser Permanente ◽  
Men And Women ◽  
Genome Wide ◽  
Cornell Voltage

Electrocardiographic (ECG)-derived left ventricular hypertrophy (LVH) is a recognized phenotype of hypertensive target organ damage and an independent risk factor for cardiovascular disease morbidity and mortality, and has been shown to be 20 to 40% heritable. A major prior collaborative study (EchoGen) relied on echocardiography measurement of LVH. We report here the results of the first genome-wide association study of an ECG index of LVH, the Cornell voltage, in a large US, population-based cohort. The Kaiser Permanente/UCSF Genetic Epidemiology Research on Adult Health and Aging (GERA) Cohort enrolled 110,266 persons, of whom 84,760 (77%) were of European ancestry (EA). Twelve-lead ECGs (obtained as part of routine medical care) were available in 59% (n=52,423; 62% female, mean age ± SD, 62 ± 13 years) of EA members of the GERA cohort. For those with more than 1 ECG (75%), one was selected at random. We programmatically derived from the digital tracings the Cornell voltage as R in aVL plus S in V3 (in mV). Mean ± SD Cornell voltages were 1.39 ± 0.58 mV in men and 1.16 ± 0.55 mV in women. Genotypes were generated on 674,518 SNPs using a custom designed Affymetrix Axiom array, and imputation was conducted using the 1000 Genomes data as a reference set. We identified 10 genetic loci (nearest genes: NFIA, CRIM1, CCDC141, HAND1, VGLL2, CTNNA, TBX3, SIPA1L1, ZNF595, and PROCR) with genome-wide significant associations (p<5*10 -8 ) with Cornell voltage as a continuous variable. Five of the loci (NFIA, CRIM1, HAND1, TBX3, and SIPA1L1) have previously been reported to influence QRS and PR intervals, while the other loci are novel. Interestingly, none of these loci were associated with left ventricular mass in the EchoGen consortium. Sex-specific analyses supported the association of these loci in both men and women; six loci were associated at a genome-wide significant level in these stratified analyses, including TBX3 and ZNF595 in both men and women, CCDC141, SIPA1L1, and PROCR in men, and VGLL2 in women, despite reduced sample sizes. These results may help elucidate both the biological and genetic basis of this clinically relevant phenotype.

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