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. 2022 Mar 8;8(1):51-58.
doi: 10.1016/j.cdtm.2021.08.001. eCollection 2022 Mar.

QRS score: A simple marker to quantify the extent of myocardial scarring in patients with chronic total arterial occlusion

Hongzhou Guo  1 , Xuan Zhou  2 , Jiaying Xu  2 , Zhishuai Ye  1 , Lei Guo  2 , Rongchong Huang  1   2
Affiliations

QRS score: A simple marker to quantify the extent of myocardial scarring in patients with chronic total arterial occlusion

Hongzhou Guo et al. Chronic Dis Transl Med. .

Abstract

Background: Chronic total occlusion (CTO) is a critical and unique subgroup of coronary lesions. This study aimed to investigate the correlation between the Selvester QRS score and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMRI) in quantifying myocardial scarring to provide a simple and feasible method for treating CTO.

Methods: The medical records of 134 patients with absolute CTO who underwent coronary angiography between May 1, 2014 and December 30, 2017 were retrospectively reviewed. All patients were grouped according to the CTO location (right coronary artery [RCA] CTO, left artery descending [LAD] CTO, left circumflex [LCX] CTO, and multivessel CTO groups). The degree of myocardial scarring was determined according to the Selvester QRS score and using the LGE-CMRI. All patients were followed up for at least 12 months.

Results: Among the 62 CTO patients, 55 had occlusion of a single vessel and seven had occlusion of multiple vessels, of which 27 (43.55%) were in the RCA CTO group, 16 (25.81%) in the LAD CTO group, 12 (19.35%) in the LCX CTO group, and 7 (11.29%) in the multivessel CTO group. The area under the receiver operating characteristic curve for the QRS score that was used to determine the degree of myocardial scarring was 0.806, with a sensitivity and specificity of 94.7% and 42.1%, respectively. The Selvester QRS score and LGE-CMRI measures of scar size were correlated in the RCA CTO, LCX CTO, and multivessel CTO groups (r = 0.466, 0.593, and 0.775, respectively).

Conclusion: The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.

Keywords: Selvester QRS score; chronic total occlusion; late gadolinium enhancement cardiac magnetic resonance imaging; myocardial scar.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A flowchart of the exclusion and inclusion criteria. CAG, coronary angiography; CTA, computed tomography angiography; CTO, chronic total occlusion; DCM, dilated cardiomyopathy; ECG, electrocardiogram; HCM, hypertrophic cardiomyopathy; LBBB, left bundle branch block; LGE‐CMRI, late gadolinium enhancement cardiac magnetic resonance imaging; RBBB, right bundle branch block
Figure 2
Figure 2
A flowchart of ECG type screening when the QRS main wave is downward. ECG, electrocardiogram; LAFB, left anterior fascicular block; LBBB, left bundle branch block
Figure 3
Figure 3
A flowchart of ECG type screening when the QRS main wave is upward. ECG, electrocardiogram; LAFB, left anterior fascicular block; LBBB, left bundle branch block; RBBB, right bundle branch block
Figure 4
Figure 4
The area under the ROC curve of the QRS score was 0.806 (95% confidence interval = 0.686–0.927, p < 0.001). ROC, receiver operating characteristics
See this image and copyright information in PMC

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