title: Consideration of the impact of reperfusion therapy on the quantitative relationship between the Selvester QRS score and infarct size by cardiac MRI.
abstract: BACKGROUND
  It has previously been shown that there is a good agreement between the Selvester QRS score and myocardial infarct (MI) size determined by postmortem histopathology in patients with nonreperfused MI. Currently, however, most patients with acute coronary thrombosis receive reperfusion therapy. Therefore, the aim of this study was to test the hypothesis that early reperfusion alters the quantitative relationship between Selvester QRS score and MI size.
  
  
  METHODS
  Twenty-seven patients with acute first-time reperfused MI were studied. Infarct size was determined by delayed contrast-enhanced magnetic resonance imaging (DE-MRI) and estimated with the 50-criteria/31-point Selvester QRS scoring system 1 week after admission. The findings in the present study were compared with previous postmortem studies exploring the quantitative relationship between Selvester QRS score and MI size in nonreperfused patients.
  
  
  RESULTS
  The quantitative relationship between QRS score and MI size by DE-MRI in the present study of early reperfused MI was significantly different from previous postmortem histopathology studies of nonreperfused MI (P < 0.0001). In the present study, each QRS point represented approximately 2% of the left ventricle, compared to approximately 3% in previous postmortem histopathology studies of nonreperfused MI. When only considering small to moderate MI sizes, there was no significant difference in the quantitative relationship between QRS score and infarct size (P > 0.05).
  
  
  CONCLUSIONS
  There is a different quantitative relationship between QRS score and MI size in early reperfused MI compared to nonreperfused MI, partly explained by differences in MI size. Thus, the Selvester QRS scoring system may not be linearly related to MI size.
authors.affiliation: Department of Cardiology, University of Maastricht, The Netherlands.
authors.forename: Stephanie A M
authors.initials: SA
authors.lastname: Knippenberg
authors.forename: Galen S
authors.initials: GS
authors.lastname: Wagner
authors.forename: Joey F A
authors.initials: JF
authors.lastname: Ubachs
authors.forename: Anton
authors.initials: A
authors.lastname: Gorgels
authors.forename: Erik
authors.initials: E
authors.lastname: Hedström
authors.forename: Håkan
authors.initials: H
authors.lastname: Arheden
authors.forename: Henrik
authors.initials: H
authors.lastname: Engblom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*
chemical_list: D003287:Contrast Media