January 7, 1982New England Journal of Medicine
A QRS Scoring System for Assessing Left Ventricular Function after Myocardial Infarction
Why the study?
Does a 29-point QRS scoring system accurately estimate left ventricular ejection fraction and wall-motion abnormalities in patients after myocardial infarction?
Population
55 patients after myocardial infarction who did not have left ventricular hypertrophy or conduction…
Comparison
29-point QRS scoring system based on serial… vs Radionuclide blood-pool scanning
Design
Cross-sectional
Authors
Discussion
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Implication
May support noninvasive post-MI LVEF estimation; leaves open prospective validation before clinical adoption.
Key Points
- To evaluate a QRS scoring system for estimating left ventricular function after myocardial infarction.
- Evaluated 55 patients without left ventricular hypertrophy or conduction abnormalities.
- Used 12-lead electrocardiograms scored using a 29-point system based on Q and R wave parameters.
- Correlated scores with wall-motion abnormalities via radionuclide blood-pool scanning and left ventricular ejection fraction (LVEF).
- Scores correlated inversely with radionuclide-determined LVEF (r = -0.87).
- Score less than 3 showed 93% sensitivity and 88% specificity for severe regional dyssynergy.
- Estimated LVEF using the equation: LVEF (%) = 60 - (3 x QRS score).
Structured PICO
Does a 29-point QRS scoring system accurately estimate left ventricular ejection fraction and wall-motion abnormalities in patients after myocardial infarction?
P
Population
55 patients after myocardial infarction who did not have left ventricular hypertrophy or conduction abnormalities
I
Intervention
29-point QRS scoring system based on serial 12-lead surface electrocardiograms (duration of Q and R waves, ratios of R-to-Q and R-to-S amplitude)
C
Comparator
Radionuclide blood-pool scanning (reference standard for LVEF and wall-motion abnormalities)
O
Outcome
Severity of wall-motion abnormalities and left ventricular ejection fraction (LVEF)surrogate
A 29-point QRS scoring system derived from standard 12-lead ECGs can provide accurate, indirect quantitative estimates of left ventricular ejection fraction and infarct size after acute myocardial infarction.
Cite This Study
Palmeri et al. (1982) studied this question.