Semi-automated QRS score as a predictor of survival in CRT treated patients with strict left bundle branch block
C Reitan1, U Chaudhry2, B Atwater3
1Department of Cardiology, Clinical Sciences, Lund University, Sweden.
Insights
The Selvester QRS score, estimating myocardial scar, predicts mortality risk in Cardiac Resynchronization Therapy (CRT) patients with LBBB. Higher scores indicate a greater risk of death or heart transplant.
Area of Science:
- Cardiology
- Medical Imaging
- Electrocardiography
Background:
- Cardiac Resynchronization Therapy (CRT) improves heart failure outcomes in select patients.
- Myocardial scar negatively impacts CRT efficacy.
- The Selvester QRS scoring system quantifies myocardial scar burden via ECG.
Purpose of the Study:
- To assess the correlation between Selvester QRS scores and mortality in CRT patients.
- To determine if myocardial scar burden predicts outcomes in CRT recipients.
Main Methods:
- Retrospective analysis of 401 CRT patients with LBBB and ECG data.
- Utilized QuAReSS software for Selvester scoring.
- Cox proportional hazards models analyzed the association with death or heart transplant.
Main Results:
- Mean Selvester score was 6.4, representing 19% scar burden.
- A Selvester score >8 was significantly linked to increased mortality risk (HR 1.59, p=.014).
Conclusions:
- Elevated Selvester scores correlate with higher mortality in CRT patients with LBBB.
- The Selvester score may serve as a valuable prognostic tool for CRT patient survival.
Background:
Cardiac Resynchronization Therapy (CRT) is widely used for treating selected heart failure patients, but patients with myocardial scar respond worse to treatment. The Selvester QRS scoring system estimates myocardial scar burden using 12-lead ECG. This study's objective was to investigate the scores correlation to mortality in a CRT population.
Methods And Results:
Data on consecutive CRT patients was collected. 401 patients with LBBB and available ECG data were included in the study. QuAReSS software was used to perform Selvester scoring. Mean Selvester score was 6.4, corresponding to 19% scar burden. The endpoint was death or heart transplant; outcome was analyzed using Cox proportional hazards models. A Selvester score >8 was significantly associated with higher risk of the combined endpoint (HR 1.59, p=.014, CI 1.09-2.3).
Conclusion:
Higher Selvester scores correlate to mortality in CRT patients with strict LBBB and might be of value in prognosticating survival.
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