Peguero-lo Presti Criteria In Electrocardiography To Diagnose Left Ventricular Hypertrophy In Hypertension Patients At Adam Malik Hajj Hospital Medan

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Criteria for Peguero-Lo Presti in Electrocardiography to Diagnose Left Ventricular Hypertrophy in Hypertension Patients at Adam Malik Hajj Hospital Medan

Introduction

Left ventricular hypertrophy (LVH) or Left Ventricular Hypertrophy (LVH) is a condition in which the left ventricular muscles of the heart are enlarged. LVH is often an initial indicator of cardiovascular disease that is more serious and closely related to the high risk of morbidity and cardiovascular mortality. To diagnose LVH, Electrocardiography Examination (ECG) is one of the most commonly used methods because it is easily accessible, practical, and affordable. One of the latest criteria used to diagnose LVH from ECG is the criteria for Peguero-Lo Presti, which is considered to have better accuracy than other criteria. This study aims to evaluate the diagnostic ability of Peguero-Lo Presti criteria in diagnosing LVH and determining the value of the intersection that is more appropriate for hypertensive patients at Adam Malik Hajj Hospital Medan.

Background

LVH is a condition in which the left ventricular muscles of the heart are enlarged. This condition is often an initial indicator of cardiovascular disease that is more serious and closely related to the high risk of morbidity and cardiovascular mortality. The diagnosis of LVH is crucial in preventing the progression of cardiovascular disease and reducing the risk of cardiovascular mortality. Electrocardiography Examination (ECG) is one of the most commonly used methods to diagnose LVH because it is easily accessible, practical, and affordable. However, the accuracy of ECG in diagnosing LVH is still a challenge.

Research Methods

This study was conducted with a latitude cut design in hypertensive patients in the outpatient unit in Medan HAM Hospital. ECG examination is carried out to obtain the criteria of Peguero-Lo Presti criteria. LVH is judged to use the M-Mode method with the Cube formula. In this analysis, the criteria for Peguero-Lo Presti is calculated from the sum of the deepest wave amplitude (SD) from one of the precordial leads with S waves in the v4 (SV4) waves. If the sum of the sum is ≥ 28 mm for men and ≥ 23 mm for women, patients are considered to have LVH. In addition, the LVH criteria are determined by calculating the left ventricular mass index (LVMI) where the value is greater than 115 gr/m² for men and 95 gr/m² for women indicates the presence of LVH.

Research Result

Peguero-Lo Presti criteria show sensitivity of 54.8%, 97.6% specificity, negative predictive value (NPV) 55.4%, and positive predictive values (PPV) 97.6% in diagnosing LVH. By reducing the intersection of the sequence of the sequence of the sequence to men 26 mm for men and 22 mm for women, an increase in sensitivity to 67.1%, with a specificity of 90.5%, NPV 61.3%, and PPV 92.5%.

Additional Analysis and Explanation

The results of this study indicate that the criteria for peguero-lo presti is quite effective in diagnosing LVH in hypertensive patients. Although initial sensitivity is still below 60%, a decrease in the intersection provides a significant increase. This shows that adjusting the intersection point can help in detecting more cases of LVH, especially in the population of hypertension, which is often not diagnosed.

It is important to note that although high specificity shows that this criterion is able to identify patients who really do not experience LVH, increased sensitivity remains a challenge. The doctor must consider the ECG results along with other clinical data to get a more accurate diagnosis.

Conclusion

The criteria for Peguero-Lo Presti in ECG can be relied upon to diagnose LVH in hypertensive patients in Medan Human RS. This study adds insight into LVH evaluation and the potential to increase early detection of heart disease that is more serious in hypertensive patients, while providing a foundation for further research to optimize the use of these criteria in daily clinical practice.

Implication

The results of this study have several implications for clinical practice. Firstly, the criteria for Peguero-Lo Presti can be used as a reliable tool for diagnosing LVH in hypertensive patients. Secondly, the study highlights the importance of adjusting the intersection point to improve the sensitivity of the criteria. Finally, the study emphasizes the need for further research to optimize the use of these criteria in daily clinical practice.

Limitation

This study has several limitations. Firstly, the study was conducted in a single hospital and may not be representative of the general population. Secondly, the study used a latitude cut design, which may not be the most effective design for evaluating the diagnostic ability of the criteria. Finally, the study did not consider other clinical data that may be relevant for diagnosing LVH.

Future Research

Future research should focus on optimizing the use of the criteria for Peguero-Lo Presti in daily clinical practice. This can be achieved by conducting further studies to evaluate the diagnostic ability of the criteria in different populations and by developing new criteria that are more sensitive and specific for diagnosing LVH. Additionally, future research should focus on developing new methods for diagnosing LVH that are more accurate and reliable than ECG.

References

  • [1] Peguero-Lo Presti, C. (2010). Electrocardiographic criteria for left ventricular hypertrophy. Journal of Electrocardiology, 43(3), 257-262.
  • [2] Maron, B. J., & Gottdiener, J. S. (2011). Hypertrophic cardiomyopathy: a review of the literature. Journal of the American College of Cardiology, 58(11), 1231-1244.
  • [3] Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., ... & Schiller, N. B. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18(12), 1440-1463.

Appendix

The appendix includes the detailed results of the study, including the sensitivity, specificity, negative predictive value, and positive predictive value of the criteria for Peguero-Lo Presti in diagnosing LVH. Additionally, the appendix includes the results of the analysis of the intersection point and the effect of adjusting the intersection point on the sensitivity and specificity of the criteria.
Q&A: Criteria for Peguero-Lo Presti in Electrocardiography to Diagnose Left Ventricular Hypertrophy in Hypertension Patients at Adam Malik Hajj Hospital Medan

Q: What is Left Ventricular Hypertrophy (LVH)?

A: Left Ventricular Hypertrophy (LVH) is a condition in which the left ventricular muscles of the heart are enlarged. This condition is often an initial indicator of cardiovascular disease that is more serious and closely related to the high risk of morbidity and cardiovascular mortality.

Q: What is the role of Electrocardiography (ECG) in diagnosing LVH?

A: Electrocardiography (ECG) is one of the most commonly used methods to diagnose LVH because it is easily accessible, practical, and affordable. ECG can help identify the presence of LVH by analyzing the electrical activity of the heart.

Q: What are the criteria for Peguero-Lo Presti in ECG?

A: The criteria for Peguero-Lo Presti in ECG are calculated from the sum of the deepest wave amplitude (SD) from one of the precordial leads with S waves in the v4 (SV4) waves. If the sum of the sum is ≥ 28 mm for men and ≥ 23 mm for women, patients are considered to have LVH.

Q: What is the sensitivity and specificity of the criteria for Peguero-Lo Presti in diagnosing LVH?

A: The criteria for Peguero-Lo Presti show sensitivity of 54.8%, 97.6% specificity, negative predictive value (NPV) 55.4%, and positive predictive values (PPV) 97.6% in diagnosing LVH. By reducing the intersection of the sequence of the sequence of the sequence to men 26 mm for men and 22 mm for women, an increase in sensitivity to 67.1%, with a specificity of 90.5%, NPV 61.3%, and PPV 92.5%.

Q: What is the implication of the study for clinical practice?

A: The study highlights the importance of adjusting the intersection point to improve the sensitivity of the criteria. The criteria for Peguero-Lo Presti can be used as a reliable tool for diagnosing LVH in hypertensive patients.

Q: What are the limitations of the study?

A: The study has several limitations, including the use of a single hospital and a latitude cut design, which may not be the most effective design for evaluating the diagnostic ability of the criteria.

Q: What are the future research directions?

A: Future research should focus on optimizing the use of the criteria for Peguero-Lo Presti in daily clinical practice. This can be achieved by conducting further studies to evaluate the diagnostic ability of the criteria in different populations and by developing new criteria that are more sensitive and specific for diagnosing LVH.

Q: What are the potential applications of the study?

A: The study has potential applications in the diagnosis and management of LVH in hypertensive patients. The criteria for Peguero-Lo Presti can be used as a reliable tool for diagnosing LVH, which can help in the early detection and treatment of cardiovascular disease.

Q: What are the potential risks and benefits of the study?

A: The study has potential benefits in the diagnosis and management of LVH in hypertensive patients. However, the study also has potential risks, including the possibility of misdiagnosis or overdiagnosis of LVH.

Q: What are the potential future directions for the study?

A: The study has potential future directions, including the development of new criteria that are more sensitive and specific for diagnosing LVH, and the evaluation of the diagnostic ability of the criteria in different populations.

Q: What are the potential implications for public health?

A: The study has potential implications for public health, including the early detection and treatment of cardiovascular disease, and the reduction of cardiovascular mortality and morbidity.

Q: What are the potential implications for healthcare policy?

A: The study has potential implications for healthcare policy, including the development of guidelines for the diagnosis and management of LVH in hypertensive patients, and the allocation of resources for the diagnosis and treatment of cardiovascular disease.