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[评估不同心电图评分(QRS评分)对急性心肌梗死后左心室射血分数的估计价值]

[Evaluation of different electrocardiographic scores (QRS score) for estimating the ejection fraction of the left ventricle after acute myocardial infarct].

作者信息

Canziani R, Cozzi G, Guidali P L, Denna V, Ghiringhelli S, Piva G

出版信息

Minerva Cardioangiol. 1989 Jan-Feb;37(1-2):11-8.

PMID:2725903
Abstract

We calculated the QRS score using both the simplified Selvester's method and the Hills' one, extended to the 12 standard leads, from the electrocardiograms registered on the fifth and thirtieth day from the ischemic event from 50 infarcted patients whose radionuclide left ventricular ejection fraction was known. The analysis of our results showed a very good correlation existing between the early and the late scores (r = 0.91 Hillis's method) as well as the equivalence of the two methods as witnessed by a correlation coefficient of 0.86 on the fifth day electrocardiogram and of 0.84 on the thirtieth day E.C.G. However the correlation between QRS score and left ventricular ejection fraction was quite weak ranging from -0.36 to -0.48 depending upon the method and the moment selected for the acquisition of the data. Even the attempt to correctly select patients with a higher risk identifying a QRS score able to predict a reduced left ventricular ejection fraction (i.e. less than 40%) failed because of the low sensitivity and specificity of the method. We therefore believe that the QRS score or, at least the simplified one, is not useful to assess the residual left ventricular function after a myocardial infarction and its use should be reduced to the evaluation of the infarct size.

摘要

我们采用简化的塞尔维斯特方法和希尔斯方法,将其扩展至12个标准导联,对50例梗死患者在缺血事件发生后的第5天和第30天记录的心电图进行分析,计算QRS评分,这些患者的放射性核素左心室射血分数已知。对结果的分析表明,早期和晚期评分之间存在非常好的相关性(希利斯方法r = 0.91),两种方法具有等效性,第5天心电图的相关系数为0.86,第30天心电图的相关系数为0.84。然而,QRS评分与左心室射血分数之间的相关性相当弱,根据所选择的方法和获取数据的时间不同,范围在 -0.36至 -0.48之间。即使试图通过确定能够预测左心室射血分数降低(即小于40%)的QRS评分来正确选择高风险患者,也因该方法的低敏感性和特异性而失败。因此,我们认为QRS评分,或者至少是简化的QRS评分,对于评估心肌梗死后的左心室残余功能并无用处,其应用应仅限于评估梗死面积。

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