Automatically computed ECG algorithm for the quantification of myocardial scar and the prediction of mortality

Badertscher, Patrick and Strebel, Ivo and Honegger, Ursina and Schaerli, Nicolas and Mueller, Deborah and Puelacher, Christian and Wagener, Max and Abächerli, Roger and Walter, Joan and Sabti, Zaid and Sazgary, Lorraine and Marbot, Stella and du Fay de Lavallaz, Jeanne and Twerenbold, Raphael and Boeddinghaus, Jasper and Nestelberger, Thomas and Kozhuharov, Nikola and Breidthardt, Tobias and Shrestha, Samyut and Flores, Dayana and Schumacher, Carmela and Wild, Damian and Osswald, Stefan and Zellweger, Michael J. and Mueller, Christian and Reichlin, Tobias. (2018) Automatically computed ECG algorithm for the quantification of myocardial scar and the prediction of mortality. Clinical research in cardiology, 107 (9). pp. 824-835.

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Official URL: https://edoc.unibas.ch/71165/

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Myocardial scar is associated with adverse cardiac outcomes. The Selvester QRS-score was developed to estimate myocardial scar from the 12-lead ECG, but its manual calculation is difficult. An automatically computed QRS-score would allow identification of patients with myocardial scar and an increased risk of mortality.; To assess the diagnostic and prognostic value of the automatically computed QRS-score.; The diagnostic value of the QRS-score computed automatically from a standard digital 12-lead was prospectively assessed in 2742 patients with suspected myocardial ischemia referred for myocardial perfusion imaging (MPI). The prognostic value of the QRS-score was then prospectively tested in 1151 consecutive patients presenting to the emergency department (ED) with suspected acute heart failure (AHF).; Overall, the QRS-score was significantly higher in patients with more extensive myocardial scar: the median QRS-score was 3 (IQR 2-5), 4 (IQR 2-6), and 7 (IQR 4-10) for patients with 0, 5-20 and > 20% myocardial scar as quantified by MPI (p < 0.001 for all pairwise comparisons). A QRS-score ≥ 9 (n = 284, 10%) predicted a large scar defined as > 20% of the LV with a specificity of 91% (95% CI 90-92%). Regarding clinical outcomes in patients presenting to the ED with symptoms suggestive of AHF, mortality after 1 year was 28% in patients with a QRS-score ≥ 3 as opposed to 20% in patients with a QRS-score < 3 (p = 0.001).; The QRS-score can be computed automatically from the 12-lead ECG for simple, non-invasive and inexpensive detection and quantification of myocardial scar and for the prediction of mortality. TRIAL-REGISTRATION: http://www.clinicaltrials.gov . Identifier, NCT01838148 and NCT01831115.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
UniBasel Contributors:Müller, Christian
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:05 Jul 2019 10:20
Deposited On:05 Jul 2019 10:06

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