Peguero–Lo Presti criteria modified by body surface area for the electrocardiographic diagnosis of left ventricular hypertrophy in Thai patients

Wongsakorn Luangphiphat; Atthaphon Phaisitkriengkrai; Ratikorn Methavigul; Komsing Methavigul

doi:10.2478/abm-2021-0012

Figures & Tables

Flow chart for sampling of patients whose data were included in the study. Randomized sampling was web-based (https://www.sealedenvelope.com/simple-randomiser/v1/lists). AVB, atrioventricular block; CXR, chest X-ray imaging; CRBB, complete right bundle branch block; CLBB, complete left bundle branch block; ECG, electrocardiography; HCM, hypertrophic cardiomyopathy; LV, left ventricular; LVH, left ventricular hypertropy; LAFB, left anterior fascicular block; LPFB, left posterior fascicular block; MI, myocardial infarction; RV, right ventricular; RVH, right ventricular hypertrophy.

Sensitivity and specificity of the ECG criteria against the echocardiographic LVH. Dark gray bars indicate sensitivity and open bars indicate specificity. Error bars indicate 95% confidence intervals. ECG, electrocardiographic; LVH, left ventricular hypertrophy.

AUC of the ECG criteria against the echocardiographic LVH. Dashed blue line indicates Peguero–Lo Presti criteria (AUC 0.67), solid purple line indicates Peguero–Lo Presti criteria modified by BSA (AUC 0.67), short-dashed green line indicates Sokolow–Lyon voltage criteria (AUC 0.59), and long-dashed orange line indicates Cornell voltage criteria (AUC 0.71). The teal line is for reference. AUC, area under a receiver-operating characteristic curve; BSA, body surface area; ECG, electrocardiographic; LVH, left ventricular hypertrophy.

Baseline characteristics of the patients with available echocardiography and with and without LVH

Demographic	Total n = 317 n (%) or mean ± SD	LVH n = 164 n (%) or mean ± SD	No LVH n = 153 n (%) or mean ± SD	P
Age (years)	57.2 ± 16.5	63.5 ± 13.2	50.4 ± 17.1	<0.01
Male sex	134 (42.3%)	59 (36%)	75 (49%)	0.02
Body weight (kg)	64.6 ± 15.2	64.6 ± 15.9	64.5 ± 14.5	0.98
Body surface area (m²)	1.7 ± 0.2	1.7 ± 0.2	1.7 ± 0.2	0.37
Medical history
Hypertension	151 (48)	97 (59)	54 (35)	<0.01
Diabetes mellitus	53 (17)	36 (22)	17 (11)	0.01
Dyslipidemia	158 (50)	101 (62)	57 (37)	<0.01
COPD	16 (5)	11 (7)	5 (3)	0.16
Heart failure	58 (18)	42 (26)	16 (11)	<0.01
Atrial fibrillation	57 (18)	29 (18)	28 (18)	0.89
Peripheral arterial disease	3 (1)	1 (1)	2 (1)	0.52
History of myocardial infarction	20 (6)	12 (7)	8 (5)	0.45
Valvular heart disease	76 (24)	46 (28)	30 (20)	0.08
• Aortic stenosis	8 (3)	7 (4)	1 (1)	0.04
• Aortic regurgitation	13 (4)	12 (7)	1 (1)	<0.01
• Mitral regurgitation	15 (5)	13 (8)	2 (1)	0.01
History of stroke or TIA	12 (4)	8 (5)	4 (3)	0.29
Chronic kidney disease	10 (3)	7 (4)	3 (2)	0.24
Prior PCI	22 (7)	15 (9)	7 (5)	0.11
Prior CABG	8 (3)	5 (3)	3 (2)	0.54
Echocardiographic parameters
LVEF (%)	66.5 ± 7.3	66.1 ± 7.5	67.1 ± 7.1	0.18
LV mass index (g/m²)	113.0 ± 41.1	141.6 ± 35.9	82.3 ± 17.3	<0.01
Relative wall thickness	0.6 ± 2.3	0.8 ± 3.2	0.5 ± 0.1	0.24
Medications
• Beta-blockers	95 (30)	56 (34)	39 (26)	0.09
• ACEIs/ARBs	48 (15)	32 (20)	16 (11)	0.03
• Calcium channel blockers	71 (22)	48 (29)	23 (15)	<0.01
• Diuretics	44 (14)	33 (20)	11 (7)	<0.01
SBP (mmHg)	130.1 ± 20.1	135.2 ± 20.8	124.6 ± 17.7	<0.01
DBP (mmHg)	77.1 ± 13.3	78.1 ± 13.46	76.1 ± 13.0	0.20
Creatinine (mg/dL)	1.0 ± 0.7	1.1 ± 1.0	0.9 ± 0.3	0.23
eGFR (mL/min/m²)	83.4 ± 24.4	74.5 ± 24.2	91.4 ± 21.9	<0.01

McNemar test and AUC for the electrocardiographic criteria against the echocardiographic LVH

Test	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	AUC	P AUC	^P* McNemar
Peguero–Lo Presti LVH	29.9 (23.0–37.5)	90.9 (85.1–94.9)	77.8 (65.5–87.3)	54.7 (48.4–61.0)	0.67 (0.61–0.73)	<0.01	<0.01
Modified Peguero–Lo Presti LVH	50.6 (42.7–58.5)	88.2 (82.0–92.9)	82.2 (73.3–89.1)	62.5 (55.7–69.0)	0.67 (0.61–0.73)	<0.01	<0.01
Sokolow–Lyon LVH	18.3 (12.7–25.1)	88.9 (82.8–93.4)	63.8 (48.5–77.3)	50.4 (44.2–56.5)	0.59 (0.53–0.66)	0.06	<0.01
Cornell LVH	14.0 (9.1–20.3)	98.0 (94.4–99.6)	88.5 (69.8–97.6)	51.5 (45.6–57.4)	0.71 (0.65–0.76)	0.08	<0.01

Peguero–Lo Presti criteria modified by body surface area for the electrocardiographic diagnosis of left ventricular hypertrophy in Thai patients

Figures & Tables

Figure 1

Figure 2

Figure 3

Baseline characteristics of the patients with available echocardiography and with and without LVH

McNemar test and AUC for the electrocardiographic criteria against the echocardiographic LVH

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