Selvester QRS Score Quantification Of Myocardial Scar In Patients With Chronic Total Occlusions

Objectives :Retrospective study of coronary artery disease in hospitalized patients,there is at least one coronary artery with disease chronic total occlusion(CTO).Using Selvester QRS score to quantify myocardial scar,and using delayed gadolinium enhanced cardiovascular magnetic resonance imaging(LGE-CMR)as a golden standard,to explore the correlation between the two,to provide a theoretical basis for clinical treatment of CTO.Methods : A retrospective study was made of 134 patients with absolute CTO and cardiac magnetic resonance examination who underwent coronary angiography in the Department of Cardiology,the first affiliated Hospital of Dalian Medical University,from May 2014 to December 30 th.62 patients were included,including 49 males and13 females.According to the type of coronary heart disease,26 patients have certained history of myocardial infarction,including 8 of STEMI.(ST-segment elevated myocardial infarction)? 18 of NSTEMI(Non-ST-segment elevated myocardial infarction),4 with myocardial infarction history of 2 times or more,6 showed abnormal Q wave with no clinical symptoms,and stable angina pectoris in 26 cases.Patients are also grouped according to location of occlusion vessel,RCA(Right coronary artery)CTO group,LAD(Left anterior descending coronary artery)CTO group,LCX(Left circumflex coronary artery)CTO group,multi-vessel CTO group.All the patients received standard 12-lead electrocardiogram(ECG)for Selvester score.Comparsion of Selvester QRS score and LGE-CMR measured myocardial scar.And the value of Selvester QRS score in the diagnosis of myocardial scar.Results:There were 62 patients with CTO,55 patients with single vessel CTO and 7patients with multivessel CTO.Of which 28 were in the RCA CTO group(50.9%)?14of the LAD CTO group(25.4%)?LCX CTO group 13(23.6%),7 Patients with multivessel CTO(11.29%).The QRS score as a tool to detect scar show an area underthe ROC curve was 0.806,with a sensitivity of 94.7%,specificity of 42.1%.Selvester QRS score and LGE-CMR measured scar size were correlated in the group of RCA CTO?LCX CTO?multivessel CTO,r=0.466,0.593,0.775,respectively?Conclusion:Selvester QRS score show the ability to detect myocardial scar in patients with CTO.Selvester QRS score performs moderately correlation in the group of RCA CTO and LCX CTO,high in multivessel CTO group?...