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

• 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
• Journal Title: ANNALS OF NONINVASIVE ELECTROCARDIOLOGY
• Volume: Volume 26, Number 3
• Publisher: WILEY | 2021-02-16, Pages e12829-e12829
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1111/anec.12829
• Subjects: Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; electrocardiogram; left ventricular hypertrophy; peguero‐ lo presti; repeatability; reproducibility

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.