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Short-term repeatability of the peguero-lo presti electrocardiographic left ventricular hypertrophy criteria
Dominique Drager1, Elsayed Z Soliman2, Michelle L Meyer3
1Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Insights
The Peguero-Lo Presti criteria for electrocardiographic left ventricular hypertrophy (ECG-LVH) show excellent short-term repeatability and agreement. These findings support its clinical and epidemiological use for detecting preclinical cardiovascular disease.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- Electrocardiographic left ventricular hypertrophy (ECG-LVH) signifies preclinical cardiovascular disease and predicts adverse outcomes.
- Newer Peguero-Lo Presti ECG-LVH criteria offer improved sensitivity over traditional Cornell voltage and Sokolow-Lyon criteria.
- The short-term repeatability of the Peguero-Lo Presti criteria was previously uncharacterized.
Purpose of the Study:
- To assess the short-term repeatability of the Peguero-Lo Presti ECG-LVH criteria.
- To evaluate the agreement between the Peguero-Lo Presti criteria and established Cornell voltage and Sokolow-Lyon ECG-LVH criteria.
Main Methods:
- Sixty-three participants underwent two standard 12-lead ECGs one week apart.
- The Peguero-Lo Presti index was calculated as the sum of the deepest S wave amplitude and lead V4 amplitude (SD + SV4).
- Repeatability was measured using intraclass correlation coefficients (ICC), and agreement using prevalence-adjusted bias-adjusted kappa (κ) coefficients.
Main Results:
- The Peguero-Lo Presti index demonstrated excellent repeatability with an ICC of 0.94 (95% CI: 0.91-0.97).
- High within-visit and between-visit agreement for Peguero-Lo Presti LVH was observed (κ ranging from 0.90 to 1.00).
- Agreement between Peguero-Lo Presti and Cornell or Sokolow-Lyon criteria was slightly lower (κ = 0.71).
Conclusions:
- The Peguero-Lo Presti index and LVH criteria exhibit excellent short-term repeatability and agreement.
- These findings support the utility of the Peguero-Lo Presti criteria in clinical practice and epidemiological research for identifying left ventricular hypertrophy.
Background:
Electrocardiographic left ventricular hypertrophy (ECG-LVH) represents preclinical cardiovascular disease and predicts cardiovascular disease morbidity and mortality. While the newly developed Peguero-Lo Presti ECG-LVH criteria have greater sensitivity for LVH than the Cornell voltage and Sokolow-Lyon criteria, its short-term repeatability is unknown. Therefore, we characterized the short-term repeatability of Peguero-Lo Presti ECG-LVH criteria and evaluate its agreement with Cornell voltage and Sokolow-Lyon ECG-LVH criteria.
Methods:
Participants underwent two resting, standard, 12-lead ECGs at each of two visits one week apart (n = 63). We defined a Peguero-Lo Presti index as a sum of the deepest S wave amplitude in any single lead and lead V4 (i.e., SD + SV4 ) and defined Peguero-Lo Presti LVH index as ≥ 2,300 µV among women and ≥ 2,800 µV among men. We estimated repeatability as an intraclass correlation coefficient (ICC), agreement as a prevalence-adjusted bias-adjusted kappa coefficient (κ), and precision using 95% confidence intervals (CIs).
Results:
The Peguero-Lo Presti index was repeatable: ICC (95% CI) = 0.94 (0.91-0.97). Within-visit agreement of Peguero-Lo Presti LVH was high at the first and second visits: κ (95% CI) = 0.97 (0.91-1.00) and 1.00 (1.00-1.00). Between-visit agreement of the first and second measurements at each visit was comparable: κ (95% CI) = 0.90 (0.80-1.00) and 0.93 (0.85-1.00). Agreement of Peguero-Lo Presti and Cornell or Sokolow-Lyon LVH on any one of the four ECGs was slightly lower: κ (95% CI) = 0.71 (0.54-0.89).
Conclusion:
The Peguero-Lo Presti index and LVH have excellent repeatability and agreement, which support their use in clinical and epidemiological studies.
