Document Detail

Relationship of QRS scoring system to enzymatic and pathologic infarct size: the role of infarct location.
MedLine Citation:
PMID:  3364356     Owner:  NLM     Status:  MEDLINE    
A method for estimating infarct size from 12-lead ECGs has been developed but not extensively validated. To assess its accuracy, ECG scores from 62 patients admitted to the coronary care unit at Barnes Hospital were compared to infarct size calculated from plasma MB creatine kinase (MB-CK) activity. A second cohort of 29 patients enrolled in the Multicenter Investigation of the Limitation of Infarct Size (MILIS) was evaluated as a test set and to provide pathologic correlates. Patients with conduction system disease, ventricular hypertrophy, or multiple infarctions were excluded, as were those in the Barnes group who had undergone thrombolytic therapy. ECGs obtained early (days 3 to 7 in the Barnes group and day 3 in the MILIS group) or late (days 8 to 14 in the Barnes group) were scored manually and by computer. QRS scores from early ECGs of patients with anterior infarctions correlated closely with MB-CK estimates of infarct size (r = 0.71 [Barnes] and 0.85 [MILIS] and with anatomic data (r = 0.78). Enzymatic and pathologic infarct size also correlated well (r = 0.85). Correcting for body surface area by means of total CK-derived infarct size or use of QRS scores from late ECGs did not alter the correlation coefficients. Among patients with inferior infarctions QRS scores corresponded poorly with MB-CK infarct size (r = 0.28 [Barnes] and r = -0.42 [MILIS]) and pathologic infarct size (r = -0.20), despite a significant relationship between pathologic and MB-CK estimates (r = 0.62).(ABSTRACT TRUNCATED AT 250 WORDS)
H J Eisen; B Barzilai; A S Jaffe; E M Geltman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  115     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1988 May 
Date Detail:
Created Date:  1988-05-27     Completed Date:  1988-05-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  993-1001     Citation Subset:  AIM; IM    
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110.
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MeSH Terms
Aged, 80 and over
Creatine Kinase / blood
Middle Aged
Myocardial Infarction / diagnosis*,  pathology
Myocardium / pathology
Grant Support
Reg. No./Substance:
0/Isoenzymes; EC Kinase
Comment In:
Am Heart J. 1989 Jun;117(6):1405-6   [PMID:  2729081 ]

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