Short-term repeatability of the peguero-lo presti electrocardiographic left ventricular hypertrophy criteria

• Type of Material: Article
• Authors: Dominique Drager, University of North Carolina; Elsayed Z Soliman, Wake Forest School of Medicine; Michelle L Meyer, University of North Carolina; Zhu‐Ming Zhang, Wake Forest School of Medicine; Alvaro Alonso, Emory University; Gerardo Heiss, University of North Carolina; Eric A Whitsel, University of North Carolina
• Language: English
• Date: 2021-02-16
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/anec.12829
• Title of Journal or Parent Work: ANNALS OF NONINVASIVE ELECTROCARDIOLOGY
• Volume: 26
• Issue: 3
• Start Page: e12829
• End Page: e12829
• Grant/Funding Information: This work was supported by grant (RR00046) from the General Clinical Research Centers program of the Division of Research Resources, National Institutes of Health. The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I). AA was supported by K24HL148521.
• Keywords: Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; lo presti; peguero‐ Cardiovascular System & Cardiology; repeatability; reproducibility; electrocardiogram; Science & Technology; left ventricular hypertrophy
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

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.