Evaluation of the ECG based Selvester scoring method to estimate myocardial scar burden and predict clinical outcome in patients with left bundle branch block, with comparison to late gadolinium enhancement CMR imaging
| Autor: | Robert Jablonowski, Rasmus Borgquist, Jean-Philippe Couderc, Björn Wieslander, David G. Strauss, Martin Ugander, Pyotr G. Platonov, Uzma Chaudhry, Jesper van der Pals, Henrik Engblom, Marcus Carlsson, Xiajuang Xia, Brett D. Atwater |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Bundle-Branch Block Contrast Media Gadolinium 030204 cardiovascular system & hematology Risk Assessment Severity of Illness Index 030218 nuclear medicine & medical imaging Sudden cardiac death 03 medical and health sciences QRS complex Cicatrix Electrocardiography 0302 clinical medicine Cost of Illness Predictive Value of Tests Physiology (medical) Internal medicine medicine Clinical endpoint Humans cardiovascular diseases Aged Ejection fraction Ischemic cardiomyopathy medicine.diagnostic_test business.industry Left bundle branch block Magnetic resonance imaging Heart General Medicine medicine.disease Image Enhancement Magnetic Resonance Imaging Heart failure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Corrigendum |
| Zdroj: | Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc. 22(5) |
| ISSN: | 1542-474X |
| Popis: | Background: Myocardial scar burden quantification is an emerging clinical parameter for risk stratification of sudden cardiac death and prediction of ventricular arrhythmias in patients with left ventricular dysfunction. We investigated the relationships among semiautomated Selvester score burden and late gadolinium enhancement-cardiovascular magnetic resonance (LGE-CMR) assessed scar burden and clinical outcome in patients with underlying heart failure, left bundle branch block (LBBB) and implantable cardioverter-defibrillator (ICD) treatment. Methods: Selvester QRS scoring was performed on all subjects with ischemic and nonischemic dilated cardiomyopathy at Skane University Hospital Lund (2002-2013) who had undergone LGE-CMR and 12-lead ECG with strict LBBB pre-ICD implantation. Results: Sixty patients were included; 57% nonischemic dilated cardiomyopathy and 43% ischemic cardiomyopathy with mean left ventricular ejection fraction of 27.6% ± 11.7. All patients had scar by Selvester scoring. Sixty-two percent had scar by LGE-CMR (n = 37). The Spearman correlation coefficient for LGE-CMR and Selvester score derived scar was r = .35 (p = .007). In scar negative LGE-CMR, there was evidence of scar by Selvester scoring in all patients (range 3%-33%, median 15%). Fourteen patients (23%) had an event during the follow-up period; 11 (18%) deaths and six adequate therapies (10%). There was a moderate trend indicating that presence of scar increased the risk of clinical endpoints in the LGE-CMR analysis (p = .045). Conclusion: There is a modest correlation between LGE-CMR and Selvester scoring verified myocardial scar. CMR based scar burden is correlated to clinical outcome, but Selvester scoring is not. The Selvester scoring algorithm needs to be further refined in order to be clinically relevant and reliable for detailed scar evaluation in patients with LBBB. (Less) |
| Databáze: | OpenAIRE |
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