Diagnostic performance of the Selvester QRS scoring system in relation to clinical ECG assessment of patients with lateral myocardial infarction using cardiac magnetic resonance as reference standard.
BACKGROUND
The Selvester QRS scoring system has previously been shown to enable estimation of myocardial infarct (MI) size by quantitative evaluation of the 12-lead ECG. The aim of this study was to assess the system's ability to detect and quantify lateral MI, using cardiac magnetic resonance (CMR) as reference standard.


METHODS
In 23 patients with isolated lateral infarctions MI size was assessed by CMR and estimated by QRS scoring. The ECGs were also evaluated by two cardiologists according to clinical routine.


RESULTS
The MI size estimated by QRS scoring correlated with MI size assessed by CMR (r=0.55, p=0.006). The sensitivity for lateral MI detection was 78% for QRS scoring and 39% for clinical routine ECG evaluation, respectively.


CONCLUSIONS
Selvester QRS scoring can be used to estimate size of isolated lateral MI and has a higher sensitivity for infarct detection compared to clinical routine evaluation of ECGs in these patients.
Department of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
Jonathan
J
Wiiala
Department of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden; Department of Diagnostic Radiology, Lund University and Skåne University Hospital, Lund, Sweden.
Erik
E
Hedström
Department of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
Morten
M
Kraen
Department of Heart Failure and Valvular Disease, Lund University and Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden.
Martin
M
Magnusson
Department of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
Håkan
H
Arheden
Department of Clinical Physiology, Lund University and Skåne University Hospital, Lund, Sweden. Electronic address: henrik.engblom@med.lu.se.
Henrik
H
Engblom
D000328:Adult; D000465:Algorithms; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification* / Q000175:diagnosis*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
Cardiac Magnetic Resonance; Electrocardiography; Myocardial infarction; Selvester QRS scoring