Xia Xiaojuan, Chaudhry Uzma, Wieslander Björn, Borgquist Rasmus, Wagner Galen S, Strauss David G, Platonov Pyotr, Ugander Martin, Couderc Jean-Philippe
Heart Research Follow-Up Program, University of Rochester, NY, USA.
Arrhythmia clinic, Lund University, Skane University Hospital, Lund, Sweden.
J Electrocardiol. 2015 Sep-Oct;48(5):763-8. doi: 10.1016/j.jelectrocard.2015.06.003. Epub 2015 Jun 5.
Estimation of the infarct size from body-surface ECGs in post-myocardial infarction patients has become possible using the Selvester scoring method. Automation of this scoring has been proposed in order to speed-up the measurement of the score and improving the inter-observer variability in computing a score that requires strong expertise in electrocardiography. In this work, we evaluated the quality of the QuAReSS software for delivering correct Selvester scoring in a set of standard 12-lead ECGs.
Standard 12-lead ECGs were recorded in 105 post-MI patients prescribed implantation of an implantable cardiodefibrillator (ICD). Amongst the 105 patients with standard clinical left bundle branch block (LBBB) patterns, 67 had a LBBB pattern meeting the strict criteria. The QuAReSS software was applied to these 67 tracings by two independent groups of cardiologists (from a clinical group and an ECG core laboratory) to measure the Selvester score semi-automatically. Using various level of agreement metrics, we compared the scores between groups and when automatically measured by the software.
The average of the absolute difference in Selvester scores measured by the two independent groups was 1.4±1.5 score points, whereas the difference between automatic method and the two manual adjudications were 1.2±1.2 and 1.3±1.2 points. Eighty-two percent score agreement was observed between the two independent measurements when the difference of score was within two point ranges, while 90% and 84% score agreements were reached using the automatic method compared to the two manual adjudications.
The study confirms that the QuAReSS software provides valid measurements of the Selvester score in patients with strict LBBB with minimal correction from cardiologists.
使用塞尔维斯特评分法可通过体表心电图估算心肌梗死后患者的梗死面积。为了加快评分测量速度并减少计算评分时观察者间的差异（计算该评分需要心电图方面的专业知识），有人提出对该评分进行自动化处理。在本研究中，我们评估了QuAReSS软件在一组标准12导联心电图中给出正确塞尔维斯特评分的质量。
对105例植入植入式心脏除颤器（ICD）的心肌梗死后患者记录标准12导联心电图。在105例具有标准临床左束支传导阻滞（LBBB）图形的患者中，67例符合严格标准。两组独立的心脏病专家（一组来自临床，另一组来自心电图核心实验室）将QuAReSS软件应用于这67份心电图，以半自动方式测量塞尔维斯特评分。我们使用不同程度的一致性指标，比较了两组之间以及软件自动测量时的评分。
两个独立组测量的塞尔维斯特评分的绝对差值平均值为1.4±1.5分，而自动测量方法与两次人工判定之间的差值分别为1.2±1.2分和1.3±1.2分。当评分差值在2分范围内时，两次独立测量之间的评分一致性为82%，而与两次人工判定相比，自动测量方法的评分一致性分别为90%和84%。
该研究证实，QuAReSS软件能为符合严格LBBB标准的患者提供有效的塞尔维斯特评分测量，且心脏病专家只需进行最少的校正。
