Background: The presence of Q waves at presentation with a first acute ST-segment elevation myocardial infarction(STEMI) reflects a more advanced stage of the infarction. Resolution of ST-segment elevation indicating ...Background: The presence of Q waves at presentation with a first acute ST-segment elevation myocardial infarction(STEMI) reflects a more advanced stage of the infarction. Resolution of ST-segment elevation indicating successfulmyocyte reperfusion may differ according to how far the infarction process has progressed. The Selvester QRS score measures infarct size. The purpose of this study was to evaluate the predictive value of QRS score on ST-segment resolution and 30-day clinical outcomes in patients with acute STEMI undergoing primary percutaneous coronary intervention(PCI). Methods: We conducted a prospective cohort study in 112 consecutive patients(mean age 57±11 years, 94 men, 18 women) with first acute STEMI of< 12-hour onset who underwent successful(TIMI-3 flow) primary PCI. The Selvester QRS score was estimated on the first electrocardiogram(ECG) after hospital admission. Sum of ST-segment elevation amount in millimeters was obtained immediately before angioplasty and 60 minutes after the restoration of TIMI-3 flow. The difference between 2 measurements was accepted as the amount of ST-segment resolution and expressed as ΣSTR.ΣSTR< 50%was accepted as ECG sign of no-reflow phenomenon. Follow-up to 30-day was performed. Results: The no-reflow phenomenon was more often observed in patients with high QRS score(≥4) than in those with low QRS score(34.4%and 6.3%, P< .001). Thirty-day composite major adverse cardiac event(MACE) rate was 14%in patients with high QRS score versus 0%in low QRS score group(P=.007). After adjusting for baseline characteristics, high QRS score remained a strong independent predictor of no-reflow(OR 4.1, 95%CI 1.5-10.7, P=.005) and MACE(OR 1.8, 95%CI 1.1-2.9, P=.011). Conclusions: The presence of high QRS score is an independent predictor of incomplete ST recovery and 30-day MACE in STEMI treated with primary PCI.展开更多
Background:Chronic total occlusion(CTO)is a critical and unique subgroup of coronary lesions.This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magn...Background:Chronic total occlusion(CTO)is a critical and unique subgroup of coronary lesions.This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magnetic resonance imaging(LGE-CMRI)in quantifying myocardial scarring to provide a simple and feasible method for treating CTO.Methods:The medical records of 134 patients with absolute CTO who underwent coronary angiography between May 1,2014 and December 30,2017 were retrospectively reviewed.All patients were grouped according to the CTO location(right coronary artery[RCA]CTO,left artery descending[LAD]CTO,left circumflex[LCX]CTO,and multivessel CTO groups).The degree of myocardial scarring was determined according to the Selvester QRS score and using the LGE-CMRI.All patients were followed up for at least 12 months.Results:Among the 62 CTO patients,55 had occlusion of a single vessel and seven had occlusion of multiple vessels,of which 27(43.55%)were in the RCA CTO group,16(25.81%)in the LAD CTO group,12(19.35%)in the LCX CTO group,and 7(11.29%)in the multivessel CTO group.The area under the receiver operating characteristic curve for the QRS score that was used to determine the degree of myocardial scarring was 0.806,with a sensitivity and specificity of 94.7%and 42.1%,respectively.The Selvester QRS score and LGE-CMRI measures of scar size were correlated in the RCA CTO,LCX CTO,and multivessel CTO groups(r=0.466,0.593,and 0.775,respectively).Conclusion:The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.展开更多
文摘Background: The presence of Q waves at presentation with a first acute ST-segment elevation myocardial infarction(STEMI) reflects a more advanced stage of the infarction. Resolution of ST-segment elevation indicating successfulmyocyte reperfusion may differ according to how far the infarction process has progressed. The Selvester QRS score measures infarct size. The purpose of this study was to evaluate the predictive value of QRS score on ST-segment resolution and 30-day clinical outcomes in patients with acute STEMI undergoing primary percutaneous coronary intervention(PCI). Methods: We conducted a prospective cohort study in 112 consecutive patients(mean age 57±11 years, 94 men, 18 women) with first acute STEMI of< 12-hour onset who underwent successful(TIMI-3 flow) primary PCI. The Selvester QRS score was estimated on the first electrocardiogram(ECG) after hospital admission. Sum of ST-segment elevation amount in millimeters was obtained immediately before angioplasty and 60 minutes after the restoration of TIMI-3 flow. The difference between 2 measurements was accepted as the amount of ST-segment resolution and expressed as ΣSTR.ΣSTR< 50%was accepted as ECG sign of no-reflow phenomenon. Follow-up to 30-day was performed. Results: The no-reflow phenomenon was more often observed in patients with high QRS score(≥4) than in those with low QRS score(34.4%and 6.3%, P< .001). Thirty-day composite major adverse cardiac event(MACE) rate was 14%in patients with high QRS score versus 0%in low QRS score group(P=.007). After adjusting for baseline characteristics, high QRS score remained a strong independent predictor of no-reflow(OR 4.1, 95%CI 1.5-10.7, P=.005) and MACE(OR 1.8, 95%CI 1.1-2.9, P=.011). Conclusions: The presence of high QRS score is an independent predictor of incomplete ST recovery and 30-day MACE in STEMI treated with primary PCI.
文摘Background:Chronic total occlusion(CTO)is a critical and unique subgroup of coronary lesions.This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magnetic resonance imaging(LGE-CMRI)in quantifying myocardial scarring to provide a simple and feasible method for treating CTO.Methods:The medical records of 134 patients with absolute CTO who underwent coronary angiography between May 1,2014 and December 30,2017 were retrospectively reviewed.All patients were grouped according to the CTO location(right coronary artery[RCA]CTO,left artery descending[LAD]CTO,left circumflex[LCX]CTO,and multivessel CTO groups).The degree of myocardial scarring was determined according to the Selvester QRS score and using the LGE-CMRI.All patients were followed up for at least 12 months.Results:Among the 62 CTO patients,55 had occlusion of a single vessel and seven had occlusion of multiple vessels,of which 27(43.55%)were in the RCA CTO group,16(25.81%)in the LAD CTO group,12(19.35%)in the LCX CTO group,and 7(11.29%)in the multivessel CTO group.The area under the receiver operating characteristic curve for the QRS score that was used to determine the degree of myocardial scarring was 0.806,with a sensitivity and specificity of 94.7%and 42.1%,respectively.The Selvester QRS score and LGE-CMRI measures of scar size were correlated in the RCA CTO,LCX CTO,and multivessel CTO groups(r=0.466,0.593,and 0.775,respectively).Conclusion:The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.
