Peguero-Lo Presti criteria for diagnosis of left ventricular hypertrophy: a cardiac magnetic resonance validation study

J Cardiovasc Med (Hagerstown). 2020 Jun;21(6):437-443. doi: 10.2459/JCM.0000000000000964.


Aims: The diagnostic performance of the new Peguero-Lo Presti ECG criteria for left ventricular hypertrophy (LVH) has not been validated by cardiac magnetic resonance (CMR). The aim of this study was to evaluate and compare the diagnostic performance of Peguero-Lo Presti, Cornell and Sokolow--Lyon voltage criteria for LVH as defined by CMR in an all-comers European population.

Methods: A total of 240 consecutive patients referred for CMR who had a concomitant electrocardiogram for review were evaluated. LVH group patients were defined according to the reference values for sex and age of left ventricular mass index (LVMi). A control group, adjusted by sex, was randomly selected from a population without LVH. We applied the ECG voltage criteria to both groups and evaluated their diagnostic accuracy. Diagnostic sensitivity and specificity were compared.

Results: Two hundred and forty patients (mean age 63 years; 65% men) were divided into two groups (LVH n = 149; control n = 91). The main causes of LVH were hypertension (24.8%) and hypertrophic cardiomyopathy (21.5%). The remaining patients of this group had a diagnosis of dilated cardiomyopathy (14.8%), valvular heart disease (7.4%) and infiltrative cardiomyopathy (2.0%). Overall, the sensitivity for LVH diagnosis of the Peguero-Lo Presti criteria outperformed both the Cornell (47 vs. 29%, P < 0.001) and Sokolow--Lyon voltage criteria (vs. 25%, P < 0.001). The specificities of all the criteria were above 94%, without significant differences between them.

Conclusion: In an all-comers European population with LVH defined by CMR, the criteria of Peguero-Lo Presti showed increased sensitivity for this diagnosis, when compared with the Sokolow--Lyon and Cornell voltage criteria. As such, they could become the preferred ECG diagnostic tool when evaluating patients at risk for LVH.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Electrocardiography*
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnosis*
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / physiopathology
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Portugal
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies