ECG scar quantification correlates with cardiac magnetic resonance scar size and prognostic factors in Chagas' disease

Autor(es)

Strauss, David G. ^{[1, 2]} ; Cardoso, Savio ^[3] ; Lima, Joao A. C. ^[1] ; Rochitte, Carlos E. ^[3] ; Wu, Katherine C. ^[1]

Afiliação do(s) autor(es)

^[1] Johns Hopkins Med Inst, Dept Med, Div Cardiol, Baltimore, MD 21205 - USA

^[2] US FDA, Off Sci & Engn Labs, Ctr Devices & Radiol Hlth, Silver Spring, MD - USA

^[3] Univ Sao Paulo, Sch Med, Heart Inst InCor, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: HEART; v. 97, n. 5, p. 357-361, MAR 2011.
• Citações Web of Science: 33

Resumo

Objective To test the hypothesis that 12-lead ECG QRS scoring quantifies myocardial scar and correlates with disease severity in Chagas' heart disease. Design Patients underwent 12-lead ECG for QRS scoring and cardiac magnetic resonance with late gadolinium enhancement (CMR-LGE) to assess myocardial scar. Setting University of Sao Paulo Medical School, Sao Paulo, Brazil. Patients 44 Seropositive patients with Chagas' disease without a history of myocardial infarction and at low risk for coronary artery disease. Main outcome measures Correlation between QRS score, CMR-LGE scar size and left ventricular ejection fraction. Relation between QRS score, heart failure (HF) class and history of ventricular tachycardia (VT). Results QRS score correlated directly with CMR-LGE scar size (R=0.69, p<0.0001) and inversely with left ventricular ejection fraction (R=-0.54, p=0.0002), which remained significant in the subgroup with conduction defects. Patients with class II or III HF had significantly higher QRS scores than those with class I HF (5.1 +/- 3.4 vs 2.1 +/- 3.1 QRS points (p=0.002)) and patients with a history of VT had significantly higher QRS scores than those without a history of VT (5.3 +/- 3.2% vs 2.6 +/- 3.4 QRS points (p=0.02)). A QRS score >= 2 points had particularly good sensitivity and specificity (95% and 83%, respectively) for prediction of large CMR-LGE, and a QRS score >= 7 points had particularly high specificity (92% and 89%, respectively) for predicting significant left ventricular dysfunction and history of VT. Conclusions The wide availability of 12-lead ECG makes it an attractive screening tool and may enhance clinical risk stratification of patients at risk for more severe, symptomatic Chagas' heart disease. (AU)

• Processo FAPESP: 01/04358-0 - Estudo da função ventricular e perfusão miocárdica em pacientes com Doença de Chagas: análise comparativa entre a ressonância magnética (Gd) e single photon emission computed tomography com 99mTc-MIBI e 123I-MIBG
• Beneficiário: José Claudio Meneghetti
• Modalidade de apoio: Auxílio à Pesquisa - Regular