BACKGROUND: Hypertrophic cardiomyopathy (HCM), a genetically transmitted disease, is the most common genetic cardiovascular disease. Current strategies to stratify risk are expensive and concentrated in wealthy centers. Twelve-lead electrocardiography (ECG) is inexpensive, universally available, and can be readily used for Selvester QRS scoring, which estimates scar size. This study aimed to establish the relation between ECG scar quantification and myocardial fibrosis (extent of myocardial delayed enhancement) in multidetector computed tomography (MDCT). HYPOTHESIS: There is a significant association between ECG scar quantification and the extent of myocardial delayed enhancement in MDCT. METHODS: Seventy-five patients with HCM underwent a routine clinical evaluation and echocardiography, 12-lead ECG, and MDCT study. Patients with and without an implantable cardioverter-defibrillator were included. RESULTS: The estimated Selvester QRS score of myocardial fibrosis was correlated significantly (R = 0.70; P < 0.01) with the quantified MDCT fibrosis. Compared with MDCT, the QRS score had 84.8% sensitivity and 88.8% specificity. Myocardial fibrosis was present in 88% of these patients with HCM (fibrotic mass, 9.87 ±10.8 g) comprising 5.66% ±6.16% of the total myocardial mass seen on the MDCT images. The Selvester QRS score reliably predicted the fibrotic mass in 76% of patients, which estimated 8.44% ±7.39% of the total myocardial mass. CONCLUSIONS: The Selvester QRS score provides reliable quantification of myocardial fibrosis and was well correlated with MDCT in patients with HCM.
BACKGROUND:Hypertrophic cardiomyopathy (HCM), a genetically transmitted disease, is the most common genetic cardiovascular disease. Current strategies to stratify risk are expensive and concentrated in wealthy centers. Twelve-lead electrocardiography (ECG) is inexpensive, universally available, and can be readily used for Selvester QRS scoring, which estimates scar size. This study aimed to establish the relation between ECG scar quantification and myocardial fibrosis (extent of myocardial delayed enhancement) in multidetector computed tomography (MDCT). HYPOTHESIS: There is a significant association between ECG scar quantification and the extent of myocardial delayed enhancement in MDCT. METHODS: Seventy-five patients with HCM underwent a routine clinical evaluation and echocardiography, 12-lead ECG, and MDCT study. Patients with and without an implantable cardioverter-defibrillator were included. RESULTS: The estimated Selvester QRS score of myocardial fibrosis was correlated significantly (R = 0.70; P < 0.01) with the quantified MDCT fibrosis. Compared with MDCT, the QRS score had 84.8% sensitivity and 88.8% specificity. Myocardial fibrosis was present in 88% of these patients with HCM (fibrotic mass, 9.87 ±10.8 g) comprising 5.66% ±6.16% of the total myocardial mass seen on the MDCT images. The Selvester QRS score reliably predicted the fibrotic mass in 76% of patients, which estimated 8.44% ±7.39% of the total myocardial mass. CONCLUSIONS: The Selvester QRS score provides reliable quantification of myocardial fibrosis and was well correlated with MDCT in patients with HCM.
Authors: Rocio Hinojar; José Luis Zamorano; Ariana Gonzalez Gómez; Maria Plaza Martin; Amparo Esteban; Luis Miguel Rincón; Juan Carlos Portugal; José Julio Jimenez Nácher; Covadonga Fernández-Golfín Journal: Clin Cardiol Date: 2017-06-14 Impact factor: 2.882
Authors: Björn Wieslander; Katherine C Wu; Zak Loring; Linus G Andersson; Terry F Frank; Gary Gerstenblith; Gordon F Tomaselli; Robert G Weiss; Galen S Wagner; Martin Ugander; David G Strauss Journal: J Electrocardiol Date: 2013-03-26 Impact factor: 1.438
Authors: Oliver Bruder; Anja Wagner; Christoph J Jensen; Steffen Schneider; Peter Ong; Eva-Maria Kispert; Kai Nassenstein; Thomas Schlosser; Georg V Sabin; Udo Sechtem; Heiko Mahrholdt Journal: J Am Coll Cardiol Date: 2010-06-25 Impact factor: 24.094
Authors: Raymond H Chan; Barry J Maron; Iacopo Olivotto; Michael J Pencina; Gabriele Egidy Assenza; Tammy Haas; John R Lesser; Christiane Gruner; Andrew M Crean; Harry Rakowski; James E Udelson; Ethan Rowin; Massimo Lombardi; Franco Cecchi; Benedetta Tomberli; Paolo Spirito; Francesco Formisano; Elena Biagini; Claudio Rapezzi; Carlo Nicola De Cecco; Camillo Autore; E Francis Cook; Susie N Hong; C Michael Gibson; Warren J Manning; Evan Appelbaum; Martin S Maron Journal: Circulation Date: 2014-08-05 Impact factor: 29.690
Authors: Perry M Elliott; Aris Anastasakis; Michael A Borger; Martin Borggrefe; Franco Cecchi; Philippe Charron; Albert Alain Hagege; Antoine Lafont; Giuseppe Limongelli; Heiko Mahrholdt; William J McKenna; Jens Mogensen; Petros Nihoyannopoulos; Stefano Nistri; Petronella G Pieper; Burkert Pieske; Claudio Rapezzi; Frans H Rutten; Christoph Tillmanns; Hugh Watkins Journal: Eur Heart J Date: 2014-08-29 Impact factor: 29.983