Open AccessElectrocardiography scar quantification correlates with scar size of hypertrophic cardiomyopathy seen by multidetector computed tomography
Author(s) -
Bignoto Tiago Costa,
Moreira Dalmo Antônio Ribeiro,
Habib Ricardo Garbe,
de Barros Correia Edileide,
Amarante Ricardo Carneiro,
Jatene Tannas,
Nunes Mario Barbosa Guedes,
Senra Tiago,
Mastrocolla Luiz Eduardo
Publication year - 2018
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22966
Subject(s) - medicine , hypertrophic cardiomyopathy , myocardial fibrosis , cardiology , qrs complex , electrocardiography , fibrosis , radiology , cardiac imaging , cardiomyopathy , heart failure
Background Hypertrophic cardiomyopathy (HCM), a genetically transmitted disease, is the most common genetic cardiovascular disease. Current strategies to stratify risk are expensive and concentrated in wealthy centers. Twelve‐lead electrocardiography (ECG) is inexpensive, universally available, and can be readily used for Selvester QRS scoring, which estimates scar size. This study aimed to establish the relation between ECG scar quantification and myocardial fibrosis (extent of myocardial delayed enhancement) in multidetector computed tomography (MDCT). Hypothesis There is a significant association between ECG scar quantification and the extent of myocardial delayed enhancement in MDCT. Methods Seventy‐five patients with HCM underwent a routine clinical evaluation and echocardiography, 12‐lead ECG, and MDCT study. Patients with and without an implantable cardioverter‐defibrillator were included. Results The estimated Selvester QRS score of myocardial fibrosis was correlated significantly ( R = 0.70; P < 0.01) with the quantified MDCT fibrosis. Compared with MDCT, the QRS score had 84.8% sensitivity and 88.8% specificity. Myocardial fibrosis was present in 88% of these patients with HCM (fibrotic mass, 9.87 ±10.8 g) comprising 5.66% ±6.16% of the total myocardial mass seen on the MDCT images. The Selvester QRS score reliably predicted the fibrotic mass in 76% of patients, which estimated 8.44% ±7.39% of the total myocardial mass. Conclusions The Selvester QRS score provides reliable quantification of myocardial fibrosis and was well correlated with MDCT in patients with HCM.