PDF(Pubmed)
Abstract：
The cardiovascular risk associated with left ventricular hypertrophy (LVH) in the community and, particularly, in the hypertensive fraction of the general population, represents the rationale for its timely and accurate identification in order to implement adequate preventive strategies. Although electrocardiography (ECG) is the first-line and most economical method of diagnosing LVH its accuracy is largely suboptimal. Over the last 70 years, dozens of different ECG criteria, mostly based on measurements of QRS voltages, have been proposed. In this long journey, a few years ago Peguero et al. developed a novel ECG voltage criterion, currently recognized as Peguero-Lo Presti (PLP) suggesting that it has greater sensitivity than traditional ECG-LVH criteria. Considering that in the last 5 years numerous studies have investigated the diagnostic value of this new index, this review aimed to summarize the data published so far on this topic focusing both on the accuracy in identifying the presence of LVH compared with imaging techniques such as echocardiography (ECHO) and magnetic resonance imaging (MRI) and the value in predicting hard outcomes. The evidence in favor of the greater diagnostic accuracy of the PLP criterion in detecting LVH, phenotyped by ECHO or MRI, and in the stratification of hard outcomes compared with traditional ECG criteria does not appear to be sufficiently proven. Given that the diagnosis of LVH by all ECG criteria (including the PLP) exclusively based on the QRS amplitude is largely imprecise, the development of new multiparametric ECG criteria based on artificial intelligence could represent a real improvement in the diagnostic capacity of the ECG.
摘要：
与社区LVH相关的心血管风险，特别是,在普通人群的高血压比例中，代表了及时准确识别的理由，以便实施适当的预防策略。尽管心电图（ECG）是诊断LVH的第一线和最经济的方法，但其准确性在很大程度上并不理想。在过去的七十年里，几十种不同的心电图标准，主要基于QRS电压的测量，已被提议。在这漫长的旅程中,几年前Peguero等人.开发了一种新的心电图电压判据，目前公认的Peguero-LoPresti（PLP），表明它比传统的ECG-LVH标准具有更高的灵敏度。考虑到在过去五年中，许多研究已经调查了这一新指标的诊断价值，这篇综述旨在总结迄今为止发表的关于该主题的数据,重点关注与超声心动图(ECHO)和磁共振成像(MRI)等成像技术相比,识别LVH存在的准确性以及预测硬性结局的价值.支持PLP标准在检测LVH时更高的诊断准确性的证据，通过ECHO或MRI进行表型分析，与传统ECG标准相比，在艰难结局的分层中，似乎没有得到充分证明。鉴于完全基于QRS振幅的所有ECG标准(包括PLP)对LVH的诊断在很大程度上是不精确的,基于人工智能的新多参数ECG标准的开发可以代表ECG诊断能力的真正提高。
