Comparison of Electrocardiographic Criteria for The Diagnosis of Left Ventricular

Hypertrophy in Patient with Hypertension

PRADIPTA Leo Deddy, YUANDIKA Niko Wangi1, ALFREDO1, AMANY Aida Yulia1,
SIANIPAR Jefry Pinondang1, SAFIR1
1
Dr. Kariadi Central General Hospital Semarang, Indonesia
.
OBJECTIVES
The objective was to analyse three electrocardiographic criteria for LVH compared with
transthoracic echocardiography (TTE) finding.
MATERIALS AND METHODS
This study was a-single centre, retrospective study, included 55 consecutive patients with
hypertension who had visited the cardiology clinic. EKG and TTE were performed. The
Peguero Lo-Presti criteria was calculated by adding deepest S amplitude in any precordial
lead to the S amplitude in V4 (SD + SV4). Patients with valvular abnormalities, myocardial
infarction, LV dysfunction, pericardial disease, bundle branch blocks, atrial fibrillation or
flutter, and pulmonary disease were excluded from this study.
RESULTS
We found 31 hypertensive patients (56%) had LVH by TTE. Of the 55 patients, 18
patients had LVH based on Peguero Lo-Presti criteria with a sensitivity of 58.06%. Cornell
Voltage criteria was positive in 8 out of 55 patients with a sensitivity of 25.81% and
Sokolow-Lyon criteria was positive in 6 out of 55 with a sensitivity of 19.35%. The Peguero
Lo-Presti EKG criteria had a higher sensitivity (58.06%) and specificity (91.67%) in the
diagnosis of LVH than traditional criteria.
CONCLUSION
Peguero Lo-Presti criteria for diagnosing LVH is more sensitive and specific than
Sokolow-Lyon and Cornell voltage criteria. Perhaps it is due to the latter component of the
QRS complex, which corresponds to the S wave, better represents voltage variations in
patients with LVH.
Table 1. Characteristics and correlation of each criteria to diagnose LVH

Specificit
Criteria Sensitivity Accuracy PPV NPV
y
Cornel 25.81 83.33 47.27 60 44.4
Sokolow-Lyon 19.35 87.5 52.73 72.73 47.73
Peguero Lo Presti 58.06 91.67 72.73 90 62.86
PPV = positive predictive value; NPV: negative predictive value

Correlatio
HHD n p
Coefficient
Yes No
Yes 8 (72.7) 3 (27.3)
Cornel 0.163 0.221
No 23 (52.3) 21 (47.7)
Yes 6 (60) 4 (40)
Sokolow-Lyon 0.035 0.798
No 25 (55.6) 20 (44.4)
Yes 18 (90) 2 (10)
Peguero Lo Presti 0.523 <0.001
No 13 (37.1) 22 (62.9)
Total 31 (56.4) 24 (43.6)