The Selvester QRS Score is more accurate than Q waves and fragmented QRS complexes using the Mason-Likar configuration in estimating infarct volume in patients with ischemic cardiomyopathy.
Infarct volume independently predicts cardiovascular events. Fragmented QRS complexes (fQRS) may complement Q waves for identifying infarction; however, their utility in advanced coronary disease is unknown. We tested whether fQRS could improve the electrocardiographic prediction of infarct volume by positron emission tomography in 138 patients with ischemic cardiomyopathy (ejection fraction, 0.27 +/- 0.09). Indices of infarction (pathologic Q waves, fQRS, and Selvester QRS Score) were analyzed by blinded observers. In patients with QRS duration less than 120 milliseconds, number of leads with pathologic Q waves (mean, 1.6 +/- 1.7) correlated weakly with infarct volume (r = 0.30, P < .05). Adding fQRS increased the number of affected leads (3.6 +/- 2.5), but the significant correlation with infarct volume was lost (r = 0.02, P = .10). Selvester Score was the most accurate (mean, 5.9 +/- 4.9 points; r = 0.49; P < .001). Fragmented QRS was not predictive of infarct size in patients with QRS duration of at least 120 milliseconds (r = 0.02, P = .19). Thus, in ischemic cardiomyopathy, consideration of fQRS complexes does not improve Q wave prediction of infarct volume; but Selvester Score was more accurate.
Carey
Mary G
MG
School of Nursing, University at Buffalo, Buffalo, NY, USA.
Luisi
Andrew J
AJ
Baldwa
Sunil
S
Al-Zaiti
Salah
S
Veneziano
Marc J
MJ
deKemp
Robert A
RA
Canty
John M
JM
Fallavollita
James A
JA
D000368:Aged; D000465:Algorithms; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
Contemp Clin Trials. 2006 Aug;27(4):374-88
16647885
Am J Cardiol. 2007 Aug 15;100(4):583-6
17697810
J Am Coll Cardiol. 2002 Apr 3;39(7):1151-8
11923039
Circulation. 1982 Feb;65(2):342-7
7053893
J Cardiovasc Nurs. 2008 Mar-Apr;23(2):175-82
18382261
Am J Cardiol. 1998 Apr 1;81(7):809-15
9555767
Am Heart J. 2005 Oct;150(4):659-65
16209961
Circulation. 2002 Jan 29;105(4):539-42
11815441
Eur J Heart Fail. 2003 Mar;5(2):165-70
12644007
Coron Artery Dis. 2007 Aug;18(5):381-9
17627188
Circulation. 2006 May 30;113(21):2495-501
16717150
Heart Rhythm. 2007 Nov;4(11):1385-92
17954396
Am Heart J. 2005 Nov;150(5):920
16290962
Circ Arrhythm Electrophysiol. 2008 Oct;1(4):258-68
19808417
J Nucl Cardiol. 2007 May-Jun;14(3):347-53
17556169
Circ Res. 2001 Feb 16;88(3):340-6
11179203
Can J Cardiol. 2005 Jan;21(1):51-6
15685303
Lancet. 2001 Jan 6;357(9249):21-8
11197356
Am J Cardiol. 1992 Feb 15;69(5):465-9
1736608
Nucl Med Commun. 2008 May;29(5):448-54
18391729
Cardiology. 2000;94(3):165-72
11279322
J Electrocardiol. 2009 Jan-Feb;42(1):85-96
18790501
J Cardiovasc Magn Reson. 2008 Apr 09;10:17
18400089
Arch Intern Med. 1985 Oct;145(10):1877-81
4037949
J Am Coll Cardiol. 2002 Nov 20;40(10):1735-43
12446055
J Card Fail. 2004 Jun;10(3):244-9
15190535
Eur Heart J. 1987 Jul;8(7):725-33
3653124
J Am Coll Cardiol. 1992 Feb;19(2):341-6
1732362