Key result
Positive terminal QRS distortion on admission ECG in STEMI patients was associated with a significantly higher total late gadolinium enhancement score on cardiac MRI compared to patients without distortion (14.7 vs 9.6).
Why the study?
Does the presence of terminal QRS distortion on admission ECG correlate with the extent and location of late gadolinium enhancement on cardiac MRI in STEMI patients?
Observational (n=50)
Blinded assessors
Does the presence of terminal QRS distortion on admission ECG correlate with the extent and location of late gadolinium enhancement on cardiac MRI in STEMI patients?
Answers are grounded in this paper and cite their sources.
Terminal QRS distortion on admission ECG in STEMI patients is associated with severe transmural infarction and larger infarct size as assessed by late gadolinium enhancement on cardiac MRI.
Large infarcts are associated with a terminal QRS-distortion in ST-elevation myocardial infarction (STEMI) patients. Late gadolinium enhancement (LGE) on the cardiac MRI (CMR) can depict an infarct distribution. However, less is known about the relationship between the LGE findings and QRS-distortion on admission, including the best ECG-lead location to reveal the QRS-distortion (DIS-lead) in STEMI patients. Fifty STEMI patients successfully treated with percutaneous coronary intervention were classified into two groups according to whether the QRS-distortion was positive (+) or negative (-). The LGE on a recent CMR was classified into 12 left ventricular segments (Basal-Middle-Apical × Anterior-Septal-Inferior-Lateral). The coincidences between the segmental LGE scores and DIS-lead were investigated. All patients were divided into 23 QRS-distortion (+) and 27 QRS-distortion (-) groups. The total LGE score was significantly greater in the QRS-distortion (+) group (14.7 ± 6.8 versus 9.6 ± 6.2, P < 0.01). The highest LGE score in 96% of QRS-distortion (+) patients was 4, and a score 4 segment indicated a good selection of the DIS-lead (86.4%). QRS-distortion in the ECG on admission represents severe transmural infarction in the LGE using CMR, which represents large infarcts in STEMI patients.
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Nimura et al. (2012) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=50). Positive terminal QRS distortion on admission ECG vs. Negative terminal QRS distortion on admission ECG was evaluated on Total late gadolinium enhancement (LGE) score on cardiac MRI (p=<0.001). Positive terminal QRS distortion on admission ECG in STEMI patients was associated with a significantly higher total late gadolinium enhancement score on cardiac MRI compared to patients without distortion (14.7 vs 9.6).
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