scholarly journals Diagnostic Ability of Peguero-Lo Presti Electrocardiographic Left Ventricular Hypertrophy Criterion in Severe Aortic Stenosis

2021 ◽  
Vol 10 (13) ◽  
pp. 2864
Author(s):  
Aleksandra Gamrat ◽  
Katarzyna Trojanowicz ◽  
Michał A. Surdacki ◽  
Aleksandra Budkiewicz ◽  
Adrianna Wąsińska ◽  
...  

Traditional electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH), introduced in the pre-echocardiographic era of diagnosis, have a relatively low sensitivity (usually not exceeding 25–40%) in detecting LVH. A novel Peguero-Lo Presti ECG-LVH criterion was recently shown to exhibit a higher sensitivity than the traditional ECG-LVH criteria in hypertension. Our aim was to test the diagnostic ability of the novel Peguero-Lo Presti ECG-LVH criterion in severe aortic stenosis. We retrospectively analyzed 12-lead ECG tracings and echocardiographic records from the index hospitalization of 50 patients with isolated severe aortic stenosis (mean age: 77 ± 10 years; 30 women and 20 men). Exclusion criteria included QRS > 120 ms, bundle branch blocks or left anterior fascicular block, a history of myocardial infarction, more than mild aortic or mitral regurgitation, and significant LV dysfunction by echocardiography. We compared the agreement of the novel Peguero-Lo Presti criterion and traditional ECG-LVH criteria with echocardiographic LVH (LV mass index > 95 g/m2 in women and >115 g/m2 in men). Echocardiographic LVH was found in 32 out of 50 study patients. The sensitivity of the Peguero-Lo Presti criterion in detecting LVH was improved (55% vs. 9–34%) at lower specificity (72% vs. 78–100%) in comparison to 8 single traditional ECG-LVH criteria. Additionally, the positive predictive value (77% vs. 72%), positive likelihood ratio (2.0 vs. 1.5), and odds ratio (3.2 vs. 2.4) were higher for the Peguero-Lo Presti criterion versus the presence of any of these 8 traditional ECG-LVH criteria. Cohen’s Kappa, a measure of concordance between ECG and echocardiography with regard to LVH, was 0.24 for the Peguero-Lo Presti criterion, −0.01–0.13 for single traditional criteria, and 0.20 for any traditional criterion. However, by the receiver operating characteristics (ROC) curve analysis, the overall ability to discriminate between patients with and without LVH was insignificantly lower for the Peguero-Lo Presti versus Cornell voltage as a continuous variable (area under the ROC curve: 0.65 (95% CI, 0.48–0.81) vs. 0.71 (0.55–0.86), p = 0.5). In conclusion, our preliminary results suggest a slightly better, albeit still low, agreement of the novel Peguero-Lo Presti ECG criterion compared to the traditional ECG-LVH criteria with echocardiographic LVH in severe aortic stenosis.

2019 ◽  
Vol 6 (10) ◽  
pp. 3786
Author(s):  
Hari Krishna Murthy P. ◽  
Abha Chandra

Background: The objective of the study was to evaluate the early outcomes and survival in patients with severe aortic stenosis associated with concentric left ventricular hypertrophy following aortic valve replacement.Methods: This is a prospective study done at SVIMS, Tirupati, from June 2014 to September 2015 evaluating out comes and survival in patients undergoing primary isolated aortic valve replacement (AVR) for severe aortic stenosis, severe aortic stenosis with mild aortic regurgitation and severe aortic stenosis with moderate aortic regurgitation.Results: A total of 40 cases 26 males and 14 females aged 18 to 60 years (mean age, 48.5±13.4 years) underwent elective AVR. Left ventricular end diastolic diameter (p=0.008) at 6 months, a statistically highly significant difference in left ventricular mass  preoperatively, at discharge, at 3rd and 6th month follow up. The difference in mean left ventricular mass index (LVMI) had declined from 244.425 to 141.100 at 6 months, showing a statistically highly significant difference in LVMI preop, at discharge, at 3rd month and at 6th month follow up.Conclusions: Patients with preoperative increase in LVMI, with large left atrial diameter carries a strong predictor of postoperative mortality for patients undergoing aortic valve surgery. We also conclude that there will be significant regression of LVMI following successful AVR. But, the decrease in LVMI is maximum during early three months and it is minimal though significant in the later course of follow up. 


Cardiology ◽  
2011 ◽  
Vol 120 (3) ◽  
pp. 139-145 ◽  
Author(s):  
Giorgio Golia ◽  
Aldo D. Milano ◽  
Mikhail Dodonov ◽  
Corinna Bergamini ◽  
Giuseppe Faggian ◽  
...  

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