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Electrocardiography scar quantification correlates with scar size of hypertrophic cardiomyopathy seen by

Tiago Costa Bignoto1, Dalmo Antônio Ribeiro Moreira1, Ricardo Garbe Habib1

  • 1Institute of Cardiology Dante Pazzanese, São Paulo, Brazil.

Clinical Cardiology
|April 20, 2018
PubMed

Insights

Electrocardiography (ECG) scar quantification using the Selvester QRS score reliably estimates myocardial fibrosis in hypertrophic cardiomyopathy (HCM) patients. This inexpensive method correlates well with multidetector computed tomography (MDCT) findings.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Genetics

Background:

  • Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disease.
  • Current risk stratification methods for HCM are costly and inaccessible.
  • Twelve-lead electrocardiography (ECG) offers a universally available and affordable tool for assessing cardiac scar burden.

Purpose of the Study:

  • To determine the relationship between ECG-based scar quantification and myocardial fibrosis extent measured by multidetector computed tomography (MDCT).
  • To validate the Selvester QRS scoring system for estimating myocardial fibrosis in HCM patients.

Main Methods:

  • Seventy-five HCM patients underwent clinical evaluation, echocardiography, 12-lead ECG, and MDCT.
  • Selvester QRS scoring was used to estimate myocardial scar size from ECG data.
  • Myocardial delayed enhancement on MDCT quantified the extent of myocardial fibrosis.

Main Results:

  • A significant correlation (R=0.70, P<0.01) was found between Selvester QRS score and MDCT-quantified fibrosis.
  • The QRS score demonstrated 84.8% sensitivity and 88.8% specificity compared to MDCT.
  • Myocardial fibrosis was detected in 88% of patients, with the Selvester QRS score accurately predicting fibrotic mass in 76% of cases.

Conclusions:

  • The Selvester QRS score is a reliable method for quantifying myocardial fibrosis in HCM.
  • ECG scar quantification using the Selvester QRS score correlates well with MDCT findings.
  • This approach offers a cost-effective and accessible tool for HCM risk stratification.
Abstract

Keywords:
Hypertrophic CardiomyopathyMDCTMyocardial Delayed EnhancementMyocardial FibrosisSelvester QRS Score

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