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

Session Poster session 2

Speaker Christina Tiller

Event : EuroCMR 2019

  • Topic : imaging
  • Sub-topic : Cardiac Magnetic Resonance
  • Session type : Poster Session

Authors : M Holzknecht (Innsbruck,AT), C Tiller (Innsbruck,AT), M Reindl (Innsbruck,AT), SJ Reinstadler (Innsbruck,AT), M Schreinlechner (Innsbruck,AT), A Peherstorfer (Innsbruck,AT), N Hein (Innsbruck,AT), A Mayr (Innsbruck,AT), G Klug (Innsbruck,AT), B Metzler (Innsbruck,AT)

M Holzknecht1 , C Tiller1 , M Reindl1 , SJ Reinstadler1 , M Schreinlechner1 , A Peherstorfer1 , N Hein1 , A Mayr2 , G Klug1 , B Metzler1 , 1Innsbruck Medical University, University Clinic of Internal Medicine III, Cardiology and Angiology - Innsbruck - Austria , 2Innsbruck Medical University, University Clinic of Radiology - Innsbruck - Austria ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 2 ), ii324

Background: Complete and simplified Selvester QRS score have been proposed as valuable clinical tools for estimation of myocardial damage in patients with ST-elevation myocardial infarction (STEMI).

Purpose: We sought to comprehensively compare both scoring systems for the prediction of myocardial injury and cardiac function assessed by cardiac magnetic resonance (CMR) imaging in patients with acute STEMI.

Methods: In this prospective observational study, 201 revascularised 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 after myocardial infarction and 4 months thereafter to determine acute and chronic infarct size (IS) as well as left ventricular (LV) dysfunction.

Results: Both complete and simplified QRS scores showed comparable predictive value for acute IS (area under the curve (AUC) =0.64 vs. AUC=0.67; AUC difference: p=0.42) and chronic IS (AUC=0.63 vs. AUC=0.68; AUC difference: p=0.22). For the prediction of acute (AUC=0.59 vs. AUC=0.71; AUC difference: p<0.001) and chronic (AUC=0.61 vs. AUC=0.69; AUC difference: p=0.03) LV dysfunction, the simplified QRS score revealed superior predictive discrimination as compared to the complete Selvester score.

Conclusions: In reperfused STEMI, complete and simplified QRS score displayed comparable value for the prediction of myocardial injury. Regarding LV dysfunction, the simplified version convinced with an even higher predictive value. Accordingly, our data propose the usage of the more practical simplified Selvester QRS score in daily clinical routine.

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