Performance of the Newly Proposed Peguero-Lo Presti Criterion in Adults with Hypertrophic Cardiomyopathy.

Abstract

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; p 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 (p = 0.533), or Peguero-Lo Presti criterion and total 12-lead voltage criterion (p = 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.