Comparison of the correlation of the Selvester QRS scoring system with cardiac contrast-enhanced magnetic resonance imaging–measured acute myocardial infarct size in patients with and without thrombolytic therapy

Rovers, Walther C.M.; van Boreen, Marit C.; Robinson, Madeleine; Martin, Thomas N.; Maynard, Charles; Wagner, Galen S.; Gorgels, Anton P.M.

doi:10.1016/j.jelectrocard.2008.12.004

« Previous Next »Journal of Electrocardiology
Volume 42, Issue 2 , Pages 139-144, March 2009

Comparison of the correlation of the Selvester QRS scoring system with cardiac contrast-enhanced magnetic resonance imaging–measured acute myocardial infarct size in patients with and without thrombolytic therapy

Walther C.M. Rovers, MD
- Department of Cardiology, University Hospital Maastricht, 6229 HX Maastricht, The Netherlands
- Corresponding author. 4904 XM Oosterhout, The Netherlands. Tel.: +31 647684801.
Marit C. van Boreen, MD
- Department of Cardiology, University Hospital Maastricht, 6229 HX Maastricht, The Netherlands
Madeleine Robinson, MD
- Department of Cardiology, Glasgow University Hospital, Western Infirmary, G11 6NT Glasgow, United Kingdom
Thomas N. Martin, MD
- Department of Cardiology, Glasgow University Hospital, Western Infirmary, G11 6NT Glasgow, United Kingdom
Charles Maynard, PhD
- Department of Health Services, University of Washington, Seattle, WA 98101, USA
Galen S. Wagner, MD
- Duke University Medical Center, Durham, NC 27705, USA
Anton P.M. Gorgels, MD
- Department of Cardiology, University Hospital Maastricht, 6229 HX Maastricht, The Netherlands

Received 17 August 2007 published online 21 January 2009.

Abstract

Background

After an acute myocardial infarction (MI), it is important to define the infarct size because it is related to mortality and morbidity. The Selvester QRS Score is an electrocardiographic (ECG) method that has been developed for estimating MI size. It has been shown to correlate well with postmortem anatomically measured sizes of single MI in patients who did not receive thrombolytic therapy. The aim of this study was to test the hypothesis that correlation between Selvester QRS Score–estimated MI size and contrast-enhanced magnetic resonance imaging (ceMRI)–measured MI size is equivalent in patients who did vs those who did not receive thrombolytic therapy.

Methods

Thirty-six patients with MI (24 with thrombolytic therapy and 12 without) received ceMRI and ECG at admission and at 1 or 6 months after admission. Indeed, in 23 of the patients, the therapy was intravenous only. The Selvester QRS Score was calculated using the 1-month ECG or, if not available, the 6-month ECG. The correlation between the 2 measures of MI size was determined for all patients and for the 2 groups separately.

Results

The mean MI size in the group that did not receive thrombolytic therapy was 8.5% ± 6.4% estimated by the Selvester QRS Score and 11.7% ± 10.2% measured by ceMRI. For the group that received thrombolytic therapy, Selvester QRS Score was 13.9% ± 11.1% and ceMRI was 20.2% ± 11.3%. The mean MI size in both groups combined was 12.1% ± 10.0% estimated by the Selvester QRS Score and 17.3% ± 11.5% measured by ceMRI. The Spearman rank correlation coefficient between Selvester QRS Score and ceMRI was 0.74 (P < .0001) for all patients, 0.74 (P < .0001) for the group that received thrombolytic therapy, and 0.64 (P = .024) for the group that did not receive thrombolytic therapy.