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. 2023 Oct 9;120(9):e20230235.
doi: 10.36660/abc.20230235. eCollection 2023.

Selvester QRS Score is a Predictor of Mortality in Heart Failure with Preserved Ejection Fraction

[Article in English, Portuguese]
Fatih Sivri  1 , Yahya Kemal Icen  2 , Hasan Koca  2 , Mükremin Coşkun  2 , Mustafa Ardınç  2 , Orshan Deniz  2 , Fatih Necip Arici  2 , Mevlüt Koc  2 , Hasan Güngör  3
Affiliations

Selvester QRS Score is a Predictor of Mortality in Heart Failure with Preserved Ejection Fraction

[Article in English, Portuguese]
Fatih Sivri et al. Arq Bras Cardiol. .

Abstract
in English, Portuguese

Background: The Selvester QRS (S-QRS) score on a 12-lead electrocardiogram (ECG) is associated with both the amount of myocardial scar and poor prognosis in myocardial infarction patients. However, its prognostic value in heart failure (HF) with preserved ejection fraction (HFpEF) is unknown.

Objective: This study aims to investigate the predictive value of the S-QRS score for mortality in HFpEF.

Methods: 359 patients were retrospectively enrolled in this study. Electrocardiographic, echocardiographic, and laboratory features of the patients were recorded. The simplified S-QRS score was measured and recorded. The mean follow-up time of the patients was 38.1±9.5 months. Statistical significance was set at p < 0.05.

Results: Of 359 patients, 270 were in the survivor group, and 89 were in the deceased group. Age, Hs-CRP, troponin, pro-BNP, left atrial (LA) diameter, LA volume index, QRS duration, Tpe, and S-QRS score were statistically high in the deceased group. In multivariate logistic regression analysis, age, Hs-CRP, NT-proBNP, LA diameter, LA volume index, Tpe, and S-QRS score were shown to be independent risk factors for mortality. In the receiver-operating characteristic (ROC) analysis, the cut-off value of the S-QRS score was 5.5, the sensitivity was 80.8%, and the specificity was 77.2% (AUC:0.880, p:0.00). In Kaplan-Meier analysis, it was found that mortality was higher in the group with S-QRS score ≥ 5.5 than in the group with S-QRS score < 5.5. (Long-rank, p:0.00).

Conclusions: We think that the S-QRS score can be used as a prognostic indicator of long-term mortality in patients with HFpEF.

Fundamento: O escore Selvester QRS (S-QRS) em um eletrocardiograma (ECG) de 12 derivações está associado tanto à quantidade de cicatriz miocárdica quanto ao mau prognóstico em pacientes com infarto do miocárdio. Entretanto, seu valor prognóstico na insuficiência cardíaca (IC) com fração de ejeção preservada (ICFEp) é desconhecido.

Objetivo: Este estudo tem como objetivo investigar o valor preditivo do escore S-QRS para mortalidade na ICFEp.

Métodos: 359 pacientes foram incluídos retrospectivamente neste estudo. As características eletrocardiográficas, ecocardiográficas e laboratoriais dos pacientes foram registradas. O escore S-QRS simplificado foi medido e registrado. O tempo médio de seguimento dos pacientes foi de 38,1±9,5 meses. A significância estatística foi estabelecida em p < 0,05.

Resultados: Dos 359 pacientes, 270 estavam no grupo sobrevivente e 89 no grupo falecido. Idade, PCR-us, troponina, pro-BNP, diâmetro do átrio esquerdo (AE), índice de volume do AE, duração do QRS, Tpe e escore do S-QRS foram estatisticamente altos no grupo falecido. Na análise de regressão logística multivariada, idade, PCR-us, NT-proBNP, diâmetro do AE, índice de volume do AE, Tpe e escore S-QRS mostraram-se fatores de risco independentes para mortalidade. Na análise da característica operacional do receptor (ROC), o valor de corte do escore S-QRS foi de 5,5, a sensibilidade foi de 80,8% e a especificidade foi de 77,2% (AUC: 0,880, p:0,00). Na análise de Kaplan-Meier, verificou-se que a mortalidade foi maior no grupo com escore S-QRS ≥ 5,5 do que no grupo com escore S-QRS < 5,5. (Long-rank, p:0,00).

Conclusão: Acreditamos que o escore S-QRS pode ser usado como um indicador prognóstico de mortalidade a longo prazo em pacientes com ICFEp.

PubMed Disclaimer

Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo

Figures

None
: O Escore de Selvester QRS é um Preditor de Mortalidade na Insuficiência Cardíaca com Fração de Ejeção Preservada
Figura 1
Figura 1. – Análise da curva ROC do escore Selvester QRS. AUC: área sob a curva; IC: intervalo de confiança.
Figura 2
Figura 2. – Análise Kaplan Meier do escore Selvester QRS. A taxa de eventos cardíacos foi significativamente maior no grupo de escore alto (HS) (linha verde) do que no grupo de escore baixo (LS) (linha azul).
None
: Selvester QRS Score is a Predictor of Mortality in Heart Failure with Preserved Ejection Fraction
Figure 1
Figure 1. – ROC curve analysis of Selvester QRS score. AUC: area under the curve; CI: confidence interval.
Figure 2
Figure 2. – Kaplan Meier analysis of Selvester QRS score. The cardiac event rate was significantly higher in the high score (HS) group (green line) than in the low score (LS) group (blue line).
See this image and copyright information in PMC

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