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[Extension of necrosis and left ventricular function in recent myocardial infarct. Correlation between a QRS scoring
Insights
The standard 12-lead ECG QRS scoring system can predict myocardial necrosis and left ventricular dysfunction after myocardial infarction. This ECG-based scoring shows significant correlation with echocardiographic measures of infarct size and ejection fraction.
Area of Science:
- Cardiology
- Medical Imaging
- Electrocardiography
Context:
- Recent myocardial infarction (MI) poses significant risks for myocardial necrosis and left ventricular (LV) dysfunction.
- Accurate assessment of infarct size and LV function is crucial for patient management and prognosis.
- Non-invasive methods for evaluating these parameters are highly desirable.
Purpose:
- To evaluate the standard 12-lead electrocardiogram (ECG) for assessing myocardial necrosis and LV function impairment in recent MI patients.
- To correlate the Wagner QRS scoring system with echocardiographic indices including echo-score, compromised areas, E-septum separation, and LV ejection fraction.
- To investigate the correlation in 105 patients with recent MI, categorized by infarction location (anterior, inferior, or both).
Summary:
- A statistically significant correlation was observed between the ECG-based QRS scoring system and echocardiographic measures of infarct size (ECG-score vs. echo-score: r=0.40; ECG-score vs. compromised areas: r=0.47).
- The QRS scoring system also showed a significant correlation with left ventricular ejection fraction (r=-0.48), particularly in patients with anterior infarction.
- No significant correlation was found between the QRS scoring system and E-septum separation.
Impact:
- The study demonstrates the statistical significance of the QRS scoring system in correlating with echocardiographic assessments of infarct size and LV function.
- While statistically significant, the clinical applicability of the QRS scoring system to individual cases is noted as minimal.
- This research supports the utility of standard ECG in providing valuable prognostic information post-myocardial infarction.
Abstract:
The purpose of this study was to evaluate the extension of myocardial necrosis and the impairment of left ventricular function in patients with recent myocardial infarction by means of the standard 12-lead ECG. Then, we tried to correlate the QRS scoring system proposed by Wagner and coll. with some indexes obtained from a M-Mode and Two-Dimensional echocardiographic examination (echo-score, number of compromised areas, E-septum separation and left ventricular ejection fraction) in a group of 105 pts. (mean age 61.54 +/- 9.66 SD years). Patients were divided into three groups: 47 with anterior infarction, 45 with inferior infarction and 13 with anterior and inferior infarction. A statistically significant correlation was found between the QRS scoring system and (a) the infarct size (r between ECG-score and echo-score = 0.40, p less than 0.001; r between ECG-score and compromised areas = 0.47, p less than 0.001) and (b) left ventricular ejection fraction (r = -0.48, p less than 0.001), measured echocardiographically, particularly in pts. with anterior infarction. No correlation was found with the E-septum separation. In conclusion, the correlation between QRS scoring system and echo indexes appeared statistically significant, even if minimally applicable to single cases.