Peguero-Lo Presti Index Calculator

Peguero–Lo Presti Index — explanation and clinical context The Peguero–Lo Presti index is an electrocardiographic voltage measurement calculated as the sum of the amplitude of the deepest S wave in any lead (Sdeepest) plus the amplitude of the S wave in lead V4 (SV4). The index is expressed in millivolts (mV). In the original derivation and subsequent validations, sex-specific cutoffs were recommended: a value > 2.3 mV for women and > 2.8 mV for men indicates electrocardiographic left ventricular hypertrophy (ECG-LVH).

The index was proposed to improve sensitivity compared with traditional ECG-LVH criteria (for example, Cornell and Sokolow–Lyon) while maintaining acceptable specificity. Clinically, a positive Peguero–Lo Presti index should prompt consideration of structural assessment (echocardiography) and evaluation for causes of LVH (hypertension, valve disease, cardiomyopathies). Because ECG voltage criteria are imperfect predictors of absolute LV mass and of prognosis by themselves, use this index as one piece of the diagnostic puzzle alongside clinical assessment and imaging.