Electrocardiographic measurement of infarct size compared to cardiac MRI in reperfused first time ST-segment elevation myocardial infarction

Holmes, L.; Nguyen, T.; Hee, L.; Otton, James; Moses, Daniel; French, John K.; Thomas, Liza; Richards, David; Juergens, C.

doi:10.1016/j.ijcard.2016.06.171

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Nowadays CMR represents the gold standard for estimating IS in vivo [1]. Concordant with our study, only moderate correlation was found between CMR derived IS and complete Selvester QRS score [21, 27].…”

Section: Discussionsupporting

confidence: 90%

“…From this model, criteria for the quantitation of myocardial infarcts from the ECG were developed [20]. Several previous studies have illustrated the usefulness of Selvester QRS scoring system for assessing myocardial necrosis [21, 22]. Before the era of hs-cTnT, positive correlation was found between Selvester QRS score and serum creatine kinase for IS estimation [23, 24].…”

Section: Discussionmentioning

confidence: 99%

“…This is consistent with the present data, naming a rate of MVO in 51% of our study population. Data concerning the relationship between Selvester QRS score and MVO are limited [21]. Watanabe et al reported in a small cohort of 62 patients with acute myocardial infarction significant correlation between simplified QRS score and CMR determined MVO volume [30].…”

Section: Discussionmentioning

confidence: 99%

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Complete versus simplified Selvester QRS score for infarct severity assessment in ST-elevation myocardial infarction

Tiller

Reindl

Reinstadler

et al. 2019

BMC Cardiovasc Disord

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BackgroundComplete and simplified Selvester QRS score have been proposed as valuable clinical tool for estimating myocardial damage in patients with ST-elevation myocardial infarction (STEMI). We sought to comprehensively compare both scoring systems for the prediction of myocardial and microvascular injury assessed by cardiac magnetic resonance (CMR) imaging in patients with acute STEMI.MethodsIn this prospective observational study, 201 revascularized STEMI patients were included. Electrocardiography was conducted at a median of 2 (interquartile range 1–4) days after the index event to evaluate the complete and simplified QRS scores. CMR was performed within 1 week and 4 months thereafter to determine acute and chronic infarct size (IS) as well as microvascular obstruction (MVO).ResultsComplete and simplified QRS score showed comparable predictive value for acute (area under the curve (AUC) = 0.64 vs. 0.67) and chronic IS (AUC = 0.63 vs. 0.68) as well as for MVO (AUC = 0.64 vs. 0.66). Peak high sensitivity cardiac troponin T (hs-cTnT) showed an AUC of 0.88 for acute IS and 0.91 for chronic IS, respectively. For the prediction of MVO, peak hs-cTnT represented an AUC of 0.81.ConclusionsIn reperfused STEMI, complete and simplified QRS score displayed comparable value for the prediction of acute and chronic myocardial as well as microvascular damage. However, both QRS scoring systems provided inferior predictive validity, compared to peak hs-cTnT, the clinical reference method for IS estimation.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Complete versus simplified Selvester QRS score for infarct severity assessment in ST-elevation myocardial infarction

Tiller

Reindl

Reinstadler

et al. 2019

BMC Cardiovasc Disord

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“…Holmes et al, 2016]. We received the most significant results in anterior MI, while only the tendency was observed in inferior MI.…”

mentioning

confidence: 73%

Differences in the Selvester QRS score after primary PCI strategy and conservative treatment for STEMI patients with negative T waves

Kalinauskienė

Gerviene

Bachárová

et al. 2019

Noninvasive Electrocardiol

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Background: According to current guidelines, the main indications for PCI in patients with STEMI are ST-segment deviations and defined time from the onset of symptoms.Negative T wave at admission can be a sign of prolonged ischemia or spontaneous reperfusion. In both situations, the urgent intervention is questionable. We evaluated the infarct size and in-hospital mortality in STEMI patients with negative T wave in cases of primary PCI strategy compared with conservative treatment.Methods: A retrospective analysis of 116 STEMI patients with negative T wave at the presenting ECG was performed. Sixty-eight patients (59%) underwent primary PCI strategy (PCI group), and 48 (41%) were treated conservatively (non-PCI group). The infarct size estimated by using the Selvester score, and in-hospital mortality were evaluated. Results:The difference between Selvester score values at admission and at discharge in the non-PCI group was statistically significant (1.48; 95% CI 0.694-2.27), while no significant difference was observed in the PCI group (−0.07; 95% CI −0.546-0.686).The in-hospital mortality was higher in the non-PCI group; however, the numbers were relatively small: PCI 2 (2.9%) and non-PCI 5 (10.4%). Conclusion:In this study, we showed a reduction in the infarct size estimated by Selvester score in STEMI patients with negative T wave who were treated conservatively, while there was no significant change in the infarct size after primary PCI strategy. The higher mortality in patients treated conservatively could be attributed to higher age and comorbidities in the non-PCI group. It seems that conservative treatment strategy might be an option in STEMI patients with negative T wave.

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Persistent T-wave inversion predicts myocardial damage after ST-elevation myocardial infarction

Reindl

Reinstadler

Feistritzer

et al. 2017

International Journal of Cardiology

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Electrocardiographic measurement of infarct size compared to cardiac MRI in reperfused first time ST-segment elevation myocardial infarction

Cited by 7 publications

References 22 publications

Complete versus simplified Selvester QRS score for infarct severity assessment in ST-elevation myocardial infarction

Complete versus simplified Selvester QRS score for infarct severity assessment in ST-elevation myocardial infarction

Differences in the Selvester QRS score after primary PCI strategy and conservative treatment for STEMI patients with negative T waves

Persistent T-wave inversion predicts myocardial damage after ST-elevation myocardial infarction

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