title: Relationships between cardiac magnetic resonance imaging abnormalities in the inter-ventricular septum and Selvester QRS scoring criteria for anterior-septal myocardial infarction in patients with right ventricular volume overload.
abstract: BACKGROUND
  Patients with ostium secundum atrial septal defects (ASDs) were studied to determine the prevalence of Selvester anteroseptal myocardial infarction QRS points, and to test the hypothesis that there is a relationship between these criteria and thinning and/or scarring of the inter-ventricular septum (IVS).
  
  
  METHODS
  Demographic, electrocardiographic (ECG), and cardiac magnetic resonance imaging (CMR) data were acquired on 46 patients with a secundum ASD closed percutaneously. Selvester QRS scoring on patient ECGs was performed for areas representing the anteroseptal region of the left ventricle (LV). The IVS to LV free wall thickness ratio was used to assess thinning of the IVS while late gadolinium enhancement (LGE) of the IVS was used for scarring; both using CMR.
  
  
  RESULTS
  Twenty-four (52%) patients scored Selvester QRS points in the anteroseptal region with a mean score of 2.6±1.8. The mean IVS/LV free wall thickness ratio at the basal level and mid-ventricular level was 1.1±0.3 and 1.3±0.3, respectively. There was no association of Selvester QRS points with IVS/LV free wall ratio at the basal (p=0.59) or mid-ventricular (p=0.13) levels. The one patient with LGE in the IVS had 4 Selvester anteroseptal QRS points.
  
  
  CONCLUSIONS
  The results of our study demonstrate that in our patient population there is a 52% prevalence of Selvester anteroseptal QRS points which are due to thinning and/or scarring of the IVS in only one patient.
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, NC, USA.
authors.forename: Adeel M
authors.initials: AM
authors.lastname: Siddiqui
authors.forename: Zainab
authors.initials: Z
authors.lastname: Samad
authors.forename: Anna Lisa C
authors.initials: AL
authors.lastname: Crowley
authors.forename: Nina
authors.initials: N
authors.lastname: Hakacova
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Harrison
authors.forename: Galen S
authors.initials: GS
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000465:Algorithms; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000175:diagnosis*; D054088:Ventricular Septum / Q000473:pathology*; D055815:Young Adult