Guo Hongzhou, Zhou Xuan, Xu Jiaying, Ye Zhishuai, Guo Lei, Huang Rongchong
Cardiac Center, Division of Cardiovascular Diseases, Beijing Friendship Hospital Capital Medical University Beijing 100050 China.
Department of Cardiology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning 116011 China.
Chronic Dis Transl Med. 2022 Mar 8;8(1):51-58. doi: 10.1016/j.cdtm.2021.08.001. eCollection 2022 Mar.
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.
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.
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 ( = 0.466, 0.593, and 0.775, respectively).
The Selvester QRS score was feasible for detecting myocardial scarring in patients with CTO.
慢性完全闭塞（CTO）是冠状动脉病变中一个关键且独特的亚组。本研究旨在探讨塞尔维斯特QRS评分与延迟钆增强心脏磁共振成像（LGE-CMRI）在量化心肌瘢痕形成方面的相关性，以提供一种简单可行的CTO治疗方法。
回顾性分析2014年5月1日至2017年12月30日期间接受冠状动脉造影的134例绝对CTO患者的病历。所有患者根据CTO位置分组（右冠状动脉[RCA]CTO组、左前降支[LAD]CTO组、左旋支[LCX]CTO组和多支血管CTO组）。根据塞尔维斯特QRS评分并使用LGE-CMRI确定心肌瘢痕形成程度。所有患者至少随访12个月。
在62例CTO患者中，55例为单支血管闭塞，7例为多支血管闭塞，其中RCA CTO组27例（43.55%），LAD CTO组16例（25.81%），LCX CTO组12例（19.35%），多支血管CTO组7例（11.29%）。用于确定心肌瘢痕形成程度的QRS评分的受试者工作特征曲线下面积为0.806，敏感性和特异性分别为94.7%和42.1%。RCA CTO组、LCX CTO组和多支血管CTO组中，塞尔维斯特QRS评分与LGE-CMRI测量的瘢痕大小相关（分别为r = 0.466、0.593和0.775）。
塞尔维斯特QRS评分在检测CTO患者心肌瘢痕形成方面是可行的。
