We examined 70 patients (55 men, 15 women), mean age 57 ± 10 years with a first time STEMI (46 anterior, 24 non-anterior). QRS scores were calculated early and at follow-up (mean 2 ± 1 and 59 ± 14 days post-STEMI). Myocardial core scar size (5SD) was measured at 5.3 ± 3.3 and 57.8 ± 13.5 days post-infarction by CMRI. MVO was determined on initial MRI. Logistic regression analysis was performed to determine factors contributing to discordant scores, defined as a difference between CMRI and Selvester IS of > 6% myocardium.
QRS scoring of anterior infarcts correlated with CMRI IS both early (r = 0.734, p < 0.0001) and at follow-up (r = 0.716, p < 0.0001); however no correlation was seen among non-anterior infarcts. QRS scoring overestimated IS at all time points. There was better agreement between ECG and CMRI measured IS in patients without MVO at both time points. Anterior infarction was inversely predictive of discordant IS estimation acutely, and larger Selvester scores were predictive of inaccurate scoring at both time periods.
Selvester QRS score correlates well with CMRI IS for anterior infarcts. MVO did not independently affect the score.