Author + information
- Received October 25, 1982
- Revision received February 9, 1983
- Accepted February 25, 1983
- Published online July 1, 1983.
- Gary S. Roubin, MB, FRACP,
- Wei Feng Shen, MSc,
- David T. Kelly, MB, FRACP, FACC and
- Phillip J. Harris, MB, DPhil, FRACP, FACC*
- ↵*Address for reprints; Dr. Phillip J. Harris, Hallstrom Institute of Cardiology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, N.S.W. 2050, Australia.
The relation between a QRS score derived from the routine electrocardiogram and left ventricular function was investigated in 181 patients after myocardial infarction. Patients with left ventricular hypertrophy and conduction defects were excluded. The QRS score correlated closely with the severity of wall motion abnormalities and left ventricular ejection fraction. The more severe the dyssynergy, the higher the QRS score (hypokinesia = 3.0; akinesia = 5.4; dyskinesia = 9.1). The left ventricular ejection fraction (percent) = 66 - (3.3 x QRS score) (correlation coefficient [r] = -0.81, probability [p] < 0.001). With use of this regression equation, the QRS score predicted angiographic left ventricular ejection fraction to within 12% of the angiographic ejection fraction in 29 of 30 additional patients studied prospectively. The QRS score was also related to clinical functional class. The worse the clinical manifestation of left ventricular dysfunction, the higher the QRS score (Killip class I = 3.5; class II = 6.5; class III = 7.1).
A QRS score greater than or equal to 7 had a specificity of 97% and a sensitivity of 59% for predicting an ejection fraction of less than 45%. Patients with a QRS score of 7 or greater had severe wall motion abnormalities, higher peak serum creatine kinase levels, higher prevalence of multivessel coronary disease, poor clinical functional class and an unfavorable outcome. The QRS score provides an inexpensive, clinically useful estimate of left ventricular function after myocardial infarction and can identify patients at high risk.
This study was supported by grants from the National Heart Foundation of Australia and the Postgraduate Foundation of the University of Sydney, Sydney, Australia.
- Received October 25, 1982.
- Revision received February 9, 1983.
- Accepted February 25, 1983.
- American College of Cardiology Foundation