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. 2018 Jun 27:5:75.
doi: 10.3389/fcvm.2018.00075. eCollection 2018.

Peguero Electrocardiographic Left Ventricular Hypertrophy Criteria and Risk of Mortality

Hesham M A Afify  1 , George S Waits  2 , Alia D Ghoneum  3 , Xiangkun Cao  2 , Yabing Li  1 , Elsayed Z Soliman  1   4
Affiliations

Peguero Electrocardiographic Left Ventricular Hypertrophy Criteria and Risk of Mortality

Hesham M A Afify et al. Front Cardiovasc Med. .

Abstract

Background: Peguero electrocardiographic left ventricular hypertrophy (ECG-LVH) criteria are newly developed criteria that have shown better diagnostic performance than the traditional Cornell-voltage and Sokolow-Lyon criteria. However, prediction of poor outcomes rather than detection of increased left ventricular mass is becoming the primary use for ECG-LVH criteria which requires investigating any new ECG-LVH criteria in terms of prediction. Aims: To examine the prognostic significance of the newly developed Peguero ECG-LVH criteria. Methods: We compared the prognostic significance of Peguero ECG-LVH with Cornell-voltage and Sokolow-Lyon ECG-LVH criteria in 7,825 participants (age 59.8 ± 13.4 years; 52.7% women) from the third National Health and Nutrition Examination Survey who were free of major intraventricular conduction defects. ECG-LVH criteria were derived from digital ECG tracings processed at a central core laboratory. Results: At baseline, ECG-LVH was detected in 11.8% by Peguero; in 4.3% by Cornell voltage and in 6.4% by Sokolow-Lyon. During a median follow up of 13.8 years, 2,796 all-cause mortality events occurred. In multivariable models adjusted for demographics and cardiovascular risk factors, presence of Peguero ECG-LVH was associated with increased risk of all-cause mortality [HR (95% CI): 1.29 (1.16, 1.44)]. This association was not significantly different from the associations of Cornell voltage-LVH or Sokolow-Lyon LVH with all-cause mortality [HR (95%CI): 1.32 (1.12, 1.55) and 1.24 (1.07, 1.43), respectively; p-values for comparisons of these HRs with the HR of Peguero ECG-LVH 0.817 and 0.667, respectively]. Similar patterns of associations were observed with cardiovascular, ischemic heart disease and heart failure mortalities. Conclusion: Peguero ECG-LVH is predictive of increased risk of death similar to the traditional ECG-LVH criteria.

Keywords: ECG-LVH; NHANES-III; Peguero ECG-LVH criteria; electrocardiogram; prognostic performance.

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Figures

Figure 1
Figure 1
This figure shows the survival probability plot for all-cause mortality by ECG-LVH status.
See this image and copyright information in PMC

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