Automatically computed ECG algorithm for the quantification of myocardial scar and the prediction of mortality
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Automatically computed ECG algorithm for the quantification of myocardial scar and the prediction of mortality. / Badertscher, Patrick; Strebel, Ivo; Honegger, Ursina; Schaerli, Nicolas; Mueller, Deborah; Puelacher, Christian; Wagener, Max; Abächerli, Roger; Walter, Joan; Sabti, Zaid; Sazgary, Lorraine; Marbot, Stella; du Fay de Lavallaz, Jeanne; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Kozhuharov, Nikola; Breidthardt, Tobias; Shrestha, Samyut; Flores, Dayana; Schumacher, Carmela; Wild, Damian; Osswald, Stefan; Zellweger, Michael J; Mueller, Christian; Reichlin, Tobias.
In: CLIN RES CARDIOL, Vol. 107, No. 9, 09.2018, p. 824-835.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Automatically computed ECG algorithm for the quantification of myocardial scar and the prediction of mortality
AU - Badertscher, Patrick
AU - Strebel, Ivo
AU - Honegger, Ursina
AU - Schaerli, Nicolas
AU - Mueller, Deborah
AU - Puelacher, Christian
AU - Wagener, Max
AU - Abächerli, Roger
AU - Walter, Joan
AU - Sabti, Zaid
AU - Sazgary, Lorraine
AU - Marbot, Stella
AU - du Fay de Lavallaz, Jeanne
AU - Twerenbold, Raphael
AU - Boeddinghaus, Jasper
AU - Nestelberger, Thomas
AU - Kozhuharov, Nikola
AU - Breidthardt, Tobias
AU - Shrestha, Samyut
AU - Flores, Dayana
AU - Schumacher, Carmela
AU - Wild, Damian
AU - Osswald, Stefan
AU - Zellweger, Michael J
AU - Mueller, Christian
AU - Reichlin, Tobias
PY - 2018/9
Y1 - 2018/9
N2 - BACKGROUND: Myocardial scar is associated with adverse cardiac outcomes. The Selvester QRS-score was developed to estimate myocardial scar from the 12-lead ECG, but its manual calculation is difficult. An automatically computed QRS-score would allow identification of patients with myocardial scar and an increased risk of mortality.OBJECTIVES: To assess the diagnostic and prognostic value of the automatically computed QRS-score.METHODS: The diagnostic value of the QRS-score computed automatically from a standard digital 12-lead was prospectively assessed in 2742 patients with suspected myocardial ischemia referred for myocardial perfusion imaging (MPI). The prognostic value of the QRS-score was then prospectively tested in 1151 consecutive patients presenting to the emergency department (ED) with suspected acute heart failure (AHF).RESULTS: Overall, the QRS-score was significantly higher in patients with more extensive myocardial scar: the median QRS-score was 3 (IQR 2-5), 4 (IQR 2-6), and 7 (IQR 4-10) for patients with 0, 5-20 and > 20% myocardial scar as quantified by MPI (p < 0.001 for all pairwise comparisons). A QRS-score ≥ 9 (n = 284, 10%) predicted a large scar defined as > 20% of the LV with a specificity of 91% (95% CI 90-92%). Regarding clinical outcomes in patients presenting to the ED with symptoms suggestive of AHF, mortality after 1 year was 28% in patients with a QRS-score ≥ 3 as opposed to 20% in patients with a QRS-score < 3 (p = 0.001).CONCLUSIONS: The QRS-score can be computed automatically from the 12-lead ECG for simple, non-invasive and inexpensive detection and quantification of myocardial scar and for the prediction of mortality. TRIAL-REGISTRATION: http://www.clinicaltrials.gov . Identifier, NCT01838148 and NCT01831115.
AB - BACKGROUND: Myocardial scar is associated with adverse cardiac outcomes. The Selvester QRS-score was developed to estimate myocardial scar from the 12-lead ECG, but its manual calculation is difficult. An automatically computed QRS-score would allow identification of patients with myocardial scar and an increased risk of mortality.OBJECTIVES: To assess the diagnostic and prognostic value of the automatically computed QRS-score.METHODS: The diagnostic value of the QRS-score computed automatically from a standard digital 12-lead was prospectively assessed in 2742 patients with suspected myocardial ischemia referred for myocardial perfusion imaging (MPI). The prognostic value of the QRS-score was then prospectively tested in 1151 consecutive patients presenting to the emergency department (ED) with suspected acute heart failure (AHF).RESULTS: Overall, the QRS-score was significantly higher in patients with more extensive myocardial scar: the median QRS-score was 3 (IQR 2-5), 4 (IQR 2-6), and 7 (IQR 4-10) for patients with 0, 5-20 and > 20% myocardial scar as quantified by MPI (p < 0.001 for all pairwise comparisons). A QRS-score ≥ 9 (n = 284, 10%) predicted a large scar defined as > 20% of the LV with a specificity of 91% (95% CI 90-92%). Regarding clinical outcomes in patients presenting to the ED with symptoms suggestive of AHF, mortality after 1 year was 28% in patients with a QRS-score ≥ 3 as opposed to 20% in patients with a QRS-score < 3 (p = 0.001).CONCLUSIONS: The QRS-score can be computed automatically from the 12-lead ECG for simple, non-invasive and inexpensive detection and quantification of myocardial scar and for the prediction of mortality. TRIAL-REGISTRATION: http://www.clinicaltrials.gov . Identifier, NCT01838148 and NCT01831115.
KW - Aged
KW - Algorithms
KW - Cicatrix/etiology
KW - Electrocardiography/methods
KW - Electronic Data Processing/methods
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Ischemia/complications
KW - Myocardium/pathology
KW - Positron-Emission Tomography
KW - Prospective Studies
KW - Reproducibility of Results
KW - Risk Factors
KW - Survival Rate/trends
KW - Switzerland/epidemiology
U2 - 10.1007/s00392-018-1253-z
DO - 10.1007/s00392-018-1253-z
M3 - SCORING: Journal article
C2 - 29667014
VL - 107
SP - 824
EP - 835
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 9
ER -
