Specificity of new diagnostic criteria for left ventricular hypertrophy

The aim of this study was to assess the recent publication of new Peguero/Lo Presti (P-LP) ECG criteria for left ventricular hypertrophy (LVH) which purported to have a higher sensitivity than commonly used existing criteria but with no significant loss of specificity (≥90%) compared to the other LVH criteria. ECGs from 1496 apparently healthy adults from the Glasgow normals ECG database were used to assess specificity. The new P-LP criteria (maximum S amplitude in any lead plus S amplitude in V4) were assessed together with the long established Sokolow-Lyon and Cornell criteria (the latter being sex based) for LVH. The Glasgow criteria were also assessed. The specificity of the new P-LP criteria were found to be exceptionally poor in younger persons, being 50% and 76% in males and females <; 30 years respectively increasing to 83% and 89% respectively in the group ≥ 50 years. The Cornell criterion specificity exceeded 90% at all ages in both sexes. New diagnostic criteria for LVH must be age and sex dependent and ideally should undergo a thorough evaluation of specificity on a large database of apparently healthy individuals from both sexes aged 18 years and over before publication.