THE VALUE OF THE QRS SCORING SYSTEM IN ASSESSING REGIONAL AND GLOBAL LEFT-VENTRICULAR EJECTION FRACTION EARLY AFTER MYOCARDIAL-INFARCTION

In 71 patients with a myocardial infarction (MI) (anterior in 27, inferior in 44 patients) global (GEF) and regional (REF) left ventricular ejection fractions were determined by radionuclide ventriculography and estimated from a 12 lead electrocardiogram (ECG), using Selvester's QRS score, during the early phase of a MI (15 to 21 days following MI). Global ejection fractions determined by radionuclide ventriculography and from ECG using Palmeri's method were: for all M140.8 ± 12.6% vs 39.6 ± 11.4%; in the group of anterior M132.0 ± 10.0% vs 30.0 ± 9.7% and in the group of inferior MI 48.9±12.0% vs 45.1 ± 8.2%. A good correlation was found between global ejection fractions determined by radionuclide ventriculography and ECG, as well as between radionuclide GEF and ECG score. A weaker correlation was found between radionuclide GEF and enzymes among all MIs and in the group of anterior MI, while in the group of inferior MI this correlation was insignificant. The analysis of REF determined by radionuclide ventriculography and ECG showed the greatest abnormalities in the infarct region, but in the group of anterior MI, dysfunction was present in the whole left ventricle. The comparison of infarct-related REF derived from radionuclide ventriculography, with the QRS score showed a significantly higher correlation than the comparison with enzymes. ECG estimation of REF from a modified Palmeri's equation showed a better correlation with radionuclide REF than did GEF derived from the standard Palmeri's equation: anterior MI; r = 0.90 vs r = 0.82, inferior MI; r = 0.84 vs r = 0.69, respectively. Our results underline the value of relatively simple ECG methods for the assessment of left ventricular global function, and new possibilities for the estimation of regional function in patients with myocardial infarction. © 1993 The Europen Society of Cardiology.