Cargando…
Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults
Recently, a new ECG criterion, the Peguero-Lo Presti (PLP), improved overall accuracy in the diagnosis of left ventricular hypertrophy (LVH)—compared to traditional ECG criteria, but with few patients with advanced age. We analyzed patients with older age and examined which ECG criteria would have b...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169892/ https://www.ncbi.nlm.nih.gov/pubmed/34075174 http://dx.doi.org/10.1038/s41598-021-91083-9 |
_version_ | 1783702118982483968 |
---|---|
author | Tavares, Caio de Assis Moura Samesima, Nelson Hajjar, Ludhmila Abrahão Godoy, Lucas C. Padrão, Eduardo Messias Hirano Lazar Neto, Felippe Facin, Mirella Jacob-Filho, Wilson Farkouh, Michael E. Pastore, Carlos Alberto |
author_facet | Tavares, Caio de Assis Moura Samesima, Nelson Hajjar, Ludhmila Abrahão Godoy, Lucas C. Padrão, Eduardo Messias Hirano Lazar Neto, Felippe Facin, Mirella Jacob-Filho, Wilson Farkouh, Michael E. Pastore, Carlos Alberto |
author_sort | Tavares, Caio de Assis Moura |
collection | PubMed |
description | Recently, a new ECG criterion, the Peguero-Lo Presti (PLP), improved overall accuracy in the diagnosis of left ventricular hypertrophy (LVH)—compared to traditional ECG criteria, but with few patients with advanced age. We analyzed patients with older age and examined which ECG criteria would have better overall performance. A total of 592 patients were included (83.1% with hypertension, mean age of 77.5 years) and the PLP criterion was compared against Cornell voltage (CV), Sokolow-Lyon voltage (SL) and Romhilt-Estes criteria (cutoffs of 4 and 5 points, RE4 and RE5, respectively) using LVH defined by the echocardiogram as the gold standard. The PLP had higher AUC than the CV, RE and SL (respectively, 0.70 vs 0.66 vs 0.64 vs 0.67), increased sensitivity compared with the SL, CV and RE5 (respectively, 51.9% [95% CI 45.4–58.3%] vs 28.2% [95% CI 22.6–34.4%], p < 0.0001; vs 35.3% [95% CI 29.2–41.7%], p < 0.0001; vs 44.4% [95% CI 38.0–50.9%], p = 0.042), highest F1 score (58.3%) and net benefit for most of the 20–60% threshold range in the decision curve analysis. Overall, despite the best diagnostic performance in older patients, the PLP criterion cannot rule out LVH consistently but can potentially be used to guide clinical decision for echocardiogram ordering in low-resource settings. |
format | Online Article Text |
id | pubmed-8169892 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-81698922021-06-03 Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults Tavares, Caio de Assis Moura Samesima, Nelson Hajjar, Ludhmila Abrahão Godoy, Lucas C. Padrão, Eduardo Messias Hirano Lazar Neto, Felippe Facin, Mirella Jacob-Filho, Wilson Farkouh, Michael E. Pastore, Carlos Alberto Sci Rep Article Recently, a new ECG criterion, the Peguero-Lo Presti (PLP), improved overall accuracy in the diagnosis of left ventricular hypertrophy (LVH)—compared to traditional ECG criteria, but with few patients with advanced age. We analyzed patients with older age and examined which ECG criteria would have better overall performance. A total of 592 patients were included (83.1% with hypertension, mean age of 77.5 years) and the PLP criterion was compared against Cornell voltage (CV), Sokolow-Lyon voltage (SL) and Romhilt-Estes criteria (cutoffs of 4 and 5 points, RE4 and RE5, respectively) using LVH defined by the echocardiogram as the gold standard. The PLP had higher AUC than the CV, RE and SL (respectively, 0.70 vs 0.66 vs 0.64 vs 0.67), increased sensitivity compared with the SL, CV and RE5 (respectively, 51.9% [95% CI 45.4–58.3%] vs 28.2% [95% CI 22.6–34.4%], p < 0.0001; vs 35.3% [95% CI 29.2–41.7%], p < 0.0001; vs 44.4% [95% CI 38.0–50.9%], p = 0.042), highest F1 score (58.3%) and net benefit for most of the 20–60% threshold range in the decision curve analysis. Overall, despite the best diagnostic performance in older patients, the PLP criterion cannot rule out LVH consistently but can potentially be used to guide clinical decision for echocardiogram ordering in low-resource settings. Nature Publishing Group UK 2021-06-01 /pmc/articles/PMC8169892/ /pubmed/34075174 http://dx.doi.org/10.1038/s41598-021-91083-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Tavares, Caio de Assis Moura Samesima, Nelson Hajjar, Ludhmila Abrahão Godoy, Lucas C. Padrão, Eduardo Messias Hirano Lazar Neto, Felippe Facin, Mirella Jacob-Filho, Wilson Farkouh, Michael E. Pastore, Carlos Alberto Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
title | Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
title_full | Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
title_fullStr | Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
title_full_unstemmed | Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
title_short | Clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
title_sort | clinical applicability and diagnostic performance of electrocardiographic criteria for left ventricular hypertrophy diagnosis in older adults |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169892/ https://www.ncbi.nlm.nih.gov/pubmed/34075174 http://dx.doi.org/10.1038/s41598-021-91083-9 |
work_keys_str_mv | AT tavarescaiodeassismoura clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT samesimanelson clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT hajjarludhmilaabrahao clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT godoylucasc clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT padraoeduardomessiashirano clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT lazarnetofelippe clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT facinmirella clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT jacobfilhowilson clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT farkouhmichaele clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults AT pastorecarlosalberto clinicalapplicabilityanddiagnosticperformanceofelectrocardiographiccriteriaforleftventricularhypertrophydiagnosisinolderadults |