Zongying Yu1, Jie Song1, Li Cheng1, Shasha Li2, Qun Lu1, Yafeng Zhang3, Xiaoci Lin4, Dadong Liu5. 1. Department of Electrocardiography, The No. 4 Affiliated Hospital of Jiangsu University, Zhenjiang, China. 2. Department of Cardiology, The No. 4 Affiliated Hospital of Jiangsu University, Zhenjiang, China. 3. Department of Infection Management, Affiliated Hospital of Jiangsu University, Zhenjiang, China. 4. Department of Internal Medicine, The First People's Hospital of Daishan, Zhejiang, China. 5. Department of Critical Care Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Abstract
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.
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.
Authors: Qingmiao Shao; Lei Meng; Gary Tse; Abhishek C Sawant; Calista Zhuo Yi Chan; George Bazoukis; Adrian Baranchuk; Guangping Li; Tong Liu Journal: Ann Noninvasive Electrocardiol Date: 2018-10-03 Impact factor: 1.468
Authors: P N Casale; R B Devereux; P Kligfield; R R Eisenberg; D H Miller; B S Chaudhary; M C Phillips Journal: J Am Coll Cardiol Date: 1985-09 Impact factor: 24.094
Authors: Sanne M Snelder; Sweder W E van de Poll; Lotte E de Groot-de Laat; Isabella Kardys; Felix Zijlstra; Bas M van Dalen Journal: Clin Cardiol Date: 2020-01-28 Impact factor: 2.882
Authors: Penny Whiting; Anne W S Rutjes; Johannes B Reitsma; Patrick M M Bossuyt; Jos Kleijnen Journal: BMC Med Res Methodol Date: 2003-11-10 Impact factor: 4.615